bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Concept of a Digital Twin and Its Potential for Learning Organizations
Authors: Berisha-Gawlowski Angelina , Caruso Carina , Harteis Christian 
Published: January 2021

AbstractThe digital transformation of organizations in the industrial sector is primarily driven by the opportunity to increase productivity while simultaneously reducing costs through integration into a cyber-physical system. One way to fully tap the potential of a cyber-physical system is the concept of the digital twin, i.e., the real-time digital representation of machines and resources involved – including human resources. The vision of representing humans by digital twins primarily aims at increasing economic benefits. The digital twin of a human, however, cannot be designed in a similar way to that of a machine. The human digital twin shall rather enable humans to act within the cyber-physical system. It therefore offers humans a power of control and the opportunity to provide feedback. The concept of the digital twin is still in its infancy and raises many questions in particular from an educational perspective. The contribution aims at answering the following questions and refers to the example of team learning: Which and how much data should and may the digital twin contain in order to support humans in their learning? To what extent will humans be able to control and design their own learning? How may skills, experiences, and social interactions of humans be represented in the digital twin; their growth and further development, respectively? With cyber-physical systems transcending corporate, national, and legal boundaries, what learning culture will be the frame of reference for the involved organizations?
The Rule of Law Framework in the European Union: Its Rationale, Origins, Role and International Ramifications
Authors: Nowak-Far Artur 
Published: January 2021

AbstractAt present, the European rule of law enforcement framework under Article 7 TEU (RLF) is vulnerable to unguaranteed, discretionary influences of the Member States. This vulnerability arises from its procedural format which requires high thresholds in decision-making with the effect that this procedure is prone to be terminated by the EU Member States likely to be scrutinized under it, if only they collude. Yet, the Framework may prove effective to correct serious breaches against human rights (in the context of ineffective rule of law standards). The European Commission is bound to pursue the RLF effectiveness for the sake of achieving relative uniformity of application of EU law (at large), and making the European Union a credible actor and co-creator of international legal order. The RLF is an important tool for the maintenance of relative stability of human rights and the rule of law in the EU despite natural divergence propensity resulting from the procedural autonomy of the EU Member States. By achieving this stability, the EU achieves significant political weight in international dialogue concerning human rights and the rule of law and preserves a high level of its global credibility in this context. Thus, RLF increases the EU’s effectiveness in promoting the European model of their identification and enforcement.
Drawing Red Lines with No (Significant) Bites: Why an Individual Test Is Not Appropriate in the LM Case
Authors: Frąckowiak-Adamska Agnieszka 
Published: January 2021

AbstractThis contribution argues that an obligation for an executing court to conduct an individual assessment in case of systemic deficiencies of the judiciary in other Member States is not an adequate tool for ensuring the respect for the rule of law. Infringements of the independence of the judiciary require other legal mechanisms of protection than fundamental rights. Moreover, individual test is often not feasible in the European judicial area as some other acts providing for recognition of judgments in the EU do not contain the mechanisms of refusal of recognition or execution. A breach of the obligation to ensure independence of the courts should logically result in suspending the participation of a given Member State in the EU policy area at stake.
Towards a Tyranny of Values?
Authors: von Bogdandy Armin 
Published: January 2021

AbstractThis contribution develops the framework of European reactions to the undermining of checks and balances in EU Member States.It surveys the normative setting with its various institutional options and contrasting constitutional principles and then applies these principles to the panoply of relevant instruments. The building blocks of this framework arecompetence,procedure,standards,andcontrol.This should help Europe to speak with a principled voice. The contribution shows how red lines can be drawn that respect constitutional pluralism, and how any action’s legitimacy is enhanced if many institutions undertake it jointly.
Approach to Musculoskeletal Examination
Authors: Almoallim Hani , Kalantan Doaa , Alharbi Laila , Albazli Khaled 
Published: January 2021

AbstractMusculoskeletal (MSK) symptoms are one of the most common reasons for patients to seek medical attention. Despite the high prevalence of musculoskeletal disorders in all fields of clinical practice, doctors continue to describe poor confidence in their musculoskeletal clinical skills. Here in this chapter an overview of the epidemiology of MSK disorders and the current status of MSK competency skills among clinicians will be discussed. Then a general approach to MSK examination will be introduced. The rest of the chapter will address detailed approach to upper limb and lower and back joints examination. Each section will start with a brief approach to pains originating from each site. Good history is part of the MSK examination.
Laboratory Interpretation of Rheumatic Diseases
Authors: Abdulkhaliq Altaf , Alotaibi Manal 
Published: January 2021

AbstractGenerally the diagnosis of rheumatic diseases is based on a set of clinical, serological, and radiological measures. The discovery of a novel test that appears to be considerably more disease-specific and preferably sensitive would be of value for the early diagnosis and immediate, effective therapy to prevent joint deterioration, functional disability, and unfavorable disease outcome [1].
Sub-leading structures in superconformal indices: subdominant saddles and logarithmic contributions
Authors: González Lezcano Alfredo , Hong Junho , Liu James T. , Pando Zayas Leopoldo A. 
Published: January 2021

Abstract
We systematically study various sub-leading structures in the superconformal index of $$ \mathcal{N} $$
N
= 4 supersymmetric Yang-Mills theory with SU(N) gauge group. We concentrate in the superconformal index description as a matrix model of elliptic gamma functions and in the Bethe-Ansatz presentation. Our saddle-point approximation goes beyond the Cardy-like limit and we uncover various saddles governed by a matrix model corresponding to SU(N) Chern-Simons theory. The dominant saddle, however, leads to perfect agreement with the Bethe-Ansatz approach. We also determine the logarithmic correction to the superconformal index to be log N, finding precise agreement between the saddle-point and Bethe-Ansatz approaches in their respective approximations. We generalize the two approaches to cover a large class of 4d $$ \mathcal{N} $$
N
= 1 superconformal theories. We find that also in this case both approximations agree all the way down to a universal contribution of the form log N. The universality of this last result constitutes a robust signature of this ultraviolet description of asymptotically AdS5 black holes and could be tested by low-energy IIB supergravity.
Variations and obstacles in the use of coagulation factor concentrates for major trauma bleeding across Europe: outcomes from a European expert meeting
Authors: Černý Vladimir , Maegele Marc , Agostini Vanessa , Fries Dietmar , Leal-Noval Santiago R. , Nardai Gábor , Nardi Giuseppe , Östlund Anders , Schöchl Herbert 
Published: January 2021

Abstract
Purpose
Trauma is a leading cause of mortality, with major bleeding and trauma-induced coagulopathy (TIC) contributing to negative patient outcomes. Treatments for TIC include tranexamic acid (TXA), fresh frozen plasma (FFP), and coagulation factor concentrates (CFCs, e.g. prothrombin complex concentrates [PCCs] and fibrinogen concentrate [FCH]). Guidelines for TIC management vary across Europe and a clear definition of TIC is still lacking.

Methods
An advisory board involving European trauma experts was held on 02 February 2019, to discuss clinical experience in the management of trauma-related bleeding and recommendations from European guidelines, focusing on CFC use (mainly FCH). This review summarises the discussions, including TIC definitions, gaps in the guidelines that affect their implementation, and barriers to use of CFCs, with suggested solutions.

Results
A definition of TIC, which incorporates clinical (e.g. severe bleeding) and laboratory parameters (e.g. low fibrinogen) is suggested. TIC should be treated immediately with TXA and FCH/red blood cells; subsequently, if fibrinogen ≤ 1.5 g/L (or equivalent by viscoelastic testing), treatment with FCH, then PCC (if bleeding continues) is suggested. Fibrinogen concentrate, and not FFP, should be administered as first-line therapy for TIC. Several initiatives may improve TIC management, with improved medical education of major importance; generation of new and stronger data, simplified clinical practice guidance, and improved access to viscoelastic testing are also critical factors.

Conclusions
Management of TIC is challenging. A standard definition of TIC, together with initiatives to facilitate effective CFC administration, may contribute to improved patient care and outcomes.
Einsatz chirurgischer Simulatoren in der Weiterbildung – eine deutschlandweite Analyse
Authors: Brunner Stefanie , Kröplin Juliane , Meyer Hans-Joachim , Schmitz‑Rixen Thomas , Fritz Tobias 
Published: January 2021

Zusammenfassung
Hintergrund
Die chirurgische Facharztweiterbildung erfordert neben dem Erlernen theoretischen Wissens ebenfalls den Erwerb praktisch-chirurgischer Kompetenzen. Eine Alternative zur Aus- und Weiterbildung am Patienten stellen simulationsbasierte Lehrkonzepte dar. Ziel der vorliegenden Studie ist die Analyse der Verteilung und des Einsatzes chirurgischer Simulatoren in deutschen Kliniken.

Methoden
Die Datenanalyse erfolgte auf Basis eines individuellen Onlinefragebogens mit insgesamt 19 standardisierten Fragen. Dieser wurde über die E‑Mail-Verteiler der deutschen chirurgischen Fachgesellschaften an die leitenden chirurgischen Klinikärzte versendet.

Ergebnisse
Insgesamt 267 vollständige Antwortdatensätze wurden analysiert (Rücklaufquote 12,0 %). 84,0 % der Teilnehmer gaben ihre Tätigkeit an einem Lehrkrankenhaus an. Zum Zeitpunkt der Untersuchung waren 143 chirurgische Simulatoren an 35,0 % der in die Auswertung eingeschlossenen Kliniken vorhanden. Regional zeigten sich deutliche Unterschiede zwischen den einzelnen Bundesländern. 21,1 % der Teilnehmer, an deren Klinik kein Simulator zur Verfügung steht, planten eine Neubeschaffung. Studierende (41,1 %) und Ärzte in Weiterbildung (ÄiW, 32,5 %) nutzten das Simulationstraining am häufigsten. Eine Integration in die chirurgische Weiterbildung bestand zu 81,8 % nicht. 94,0 % der beteiligten Kliniken zeigten Interesse an einer zukünftigen Integration in die chirurgische Facharztweiterbildung.

Schlussfolgerung
Die vorliegenden Ergebnisse bestätigen die besondere Bedeutung des simulationsbasierten Trainings für die chirurgische Weiterbildung an deutschen Kliniken. Gleichzeitig bestehen deutliche Informationsdefizite über das Nutzungsverhalten sowie eine defizitär empfundene Integration des Simulationstrainings in die chirurgische Weiterbildung.
Employing machine learning techniques to assess requirement change volatility
Authors: Hein Phyo Htet , Kames Elisabeth , Chen Cheng , Morkos Beshoy 
Published: January 2021

AbstractLack of planning when changing requirements to reflect stakeholders’ expectations can lead to propagated changes that can cause project failures. Existing tools cannot provide the formal reasoning required to manage requirement change and minimize unanticipated change propagation. This research explores machine learning techniques to predict requirement change volatility (RCV) using complex network metrics based on the premise that requirement networks can be utilized to study change propagation. Three research questions (RQs) are addressed: (1) Can RCV be measured through four classes namely, multiplier, absorber, transmitter, and robust, during every instance of change? (2) Can complex network metrics be explored and computed for each requirement during every instance of change? (3) Can machine learning techniques, specifically, multilabel learning (MLL) methods be employed to predict RCV using complex network metrics? RCV in this paper quantifies volatility for change propagation, that is, how requirements behave in response to the initial change. A multiplier is a requirement that is changed by an initial change and propagates change to other requirements. An absorber is a requirement that is changed by an initial change, but does not propagate change to other requirements. A transmitter is a requirement that is not changed by an initial change, but propagates change to other requirements. A robust requirement is a requirement that is not changed by an initial change and does not propagate change to other requirements. RCV is determined using industrial data and requirement network relationships obtained from previously developed Refined Automated Requirement Change Propagation Prediction (R-ARCPP) tool. Useful complex network metrics in highest performing machine learning models are discussed along with the limitations and future directions of this research.
Effects of iron limitation on carbon balance and photophysiology of the Antarctic diatom Chaetoceros cf. simplex
Authors: Bozzato Deborah , Jakob Torsten , Wilhelm Christian , Trimborn Scarlett 
Published: January 2021

AbstractIn the Southern Ocean (SO), iron (Fe) limitation strongly inhibits phytoplankton growth and generally decreases their primary productivity. Diatoms are a key component in the carbon (C) cycle, by taking up large amounts of anthropogenic CO2 through the biological carbon pump. In this study, we investigated the effects of Fe availability (no Fe and 4 nM FeCl3 addition) on the physiology of Chaetoceros cf. simplex, an ecologically relevant SO diatom. Our results are the first combining oxygen evolution and uptake rates with particulate organic carbon (POC) build up, pigments, photophysiological parameters and intracellular trace metal (TM) quotas in an Fe-deficient Antarctic diatom. Decreases in both oxygen evolution (through photosynthesis, P) and uptake (respiration, R) coincided with a lowered growth rate of Fe-deficient cells. In addition, cells displayed reduced electron transport rates (ETR) and chlorophyll a (Chla) content, resulting in reduced cellular POC formation. Interestingly, no differences were observed in non-photochemical quenching (NPQ) or in the ratio of gross photosynthesis to respiration (GP:R). Furthermore, TM quotas were measured, which represent an important and rarely quantified parameter in previous studies. Cellular quotas of manganese, zinc, cobalt and copper remained unchanged while Fe quotas of Fe-deficient cells were reduced by 60% compared with High Fe cells. Based on our data, Fe-deficient Chaetoceros cf. simplex cells were able to efficiently acclimate to low Fe conditions, reducing their intracellular Fe concentrations, the number of functional reaction centers of photosystem II (RCII) and photosynthetic rates, thus avoiding light absorption rather than dissipating the energy through NPQ. Our results demonstrate how Chaetoceros cf. simplex can adapt their physiology to lowered assimilatory metabolism by decreasing respiratory losses.
Small single perivascular hepatocellular carcinoma: comparisons of radiofrequency ablation and microwave ablation by using propensity score analysis
Authors: An Chao , Li Wang-Zhong , Huang Zhi-Mei , Yu Xiao-Ling , Han Yu-Zhi , Liu Fang-Yi , Wu Song-Song , Yu Jie , Liang Ping , Huang Jinhua 
Published: January 2021

AbstractObjectivesWe aimed to compare the therapeutic outcomes of radiofrequency ablation (RFA) and microwave ablation (MWA) as first-line therapies in patients with small single perivascular hepatocellular carcinoma (HCC).MethodsA total of 144 eligible patients with small (≤ 3 cm) single perivascular (proximity to hepatic and portal veins) HCC who underwent RFA (N= 70) or MWA (N= 74) as first-line treatment were included. The overall survival (OS), disease-free survival (DFS), and local tumor progression (LTP) rates between the two ablation modalities were compared. The inverse probability of treatment weighting (IPTW) method was used to reduce selection bias. Subgroup analysis was performed according to the type of hepatic vessels.ResultsAfter a median follow-up time of 38.2 months, there were no significant differences in OS (5-year OS: RFA 77.7% vs. MWA 74.6%;p= 0.600) and DFS (5-year DFS: RFA 24.7% vs. MWA 40.4%;p= 0.570). However, a significantly higher LTP rate was observed in the RFA group than the MWA group (5-year LTP: RFA 24.3% vs. MWA 8.4%;p= 0.030). IPTW-adjusted analyses revealed similar results. The treatment modality (RFA vs. MWA: HR 7.861, 95% CI 1.642–37.635,p= 0.010) was an independent prognostic factor for LTP. We observed a significant interaction effect of ablation modality and type of peritumoral vessel on LTP (p= 0.034). For patients with periportal HCC, the LTP rate was significantly higher in the RFA group than in the MWA group (p= 0.045). However, this difference was not observed in patients with perivenous HCC (p= 0.116).ConclusionsIn patients with a small single periportal HCC, MWA exhibited better tumor control than RFA.Key Points• Microwave ablation exhibited better local tumor control than radiofrequency ablation for small single periportal hepatocellular carcinoma.• There was a significant interaction between the treatment effect of ablation modality and type of peritumoral vessel on local tumor progression.• The type of peritumoral vessel is vital in choosing ablation modalities for hepatocellular carcinoma.
Air-Sea interaction over the Gulf Stream in an ensemble of HighResMIP present climate simulations
Authors: Bellucci Alessio , Athanasiadis P. J. , Scoccimarro E. , Ruggieri P. , Gualdi S. , Fedele G. , Haarsma R. J. , Garcia-Serrano J. , Castrillo M. , Putrahasan D. , Sanchez-Gomez E. , Moine M.-P. , Roberts C. D. , Roberts M. J. , Seddon J. , Vidale P. L. 
Published: January 2021

AbstractA dominant paradigm for mid-latitude air-sea interaction identifies the synoptic-scale atmospheric “noise” as the main driver for the observed ocean surface variability. While this conceptual model successfully holds over most of the mid-latitude ocean surface, its soundness over frontal zones (including western boundary currents; WBC) characterized by intense mesoscale activity, has been questioned in a number of studies suggesting a driving role for the small scale ocean dynamics (mesoscale oceanic eddies) in the modulation of air-sea interaction. In this context, climate models provide a powerful experimental device to inspect the emerging scale-dependent nature of mid-latitude air-sea interaction. This study assesses the impact of model resolution on the representation of air-sea interaction over the Gulf Stream region, in a multi-model ensemble of present-climate simulations performed using a common experimental design. Lead-lag correlation and covariance patterns between sea surface temperature (SST) and turbulent heat flux (THF) are diagnosed to identify the leading regimes of air-sea interaction in a region encompassing both the Gulf Stream system and the North Atlantic subtropical basin. Based on these statistical metrics it is found that coupled models based on “laminar” (eddy-parameterised) and eddy-permitting oceans are able to discriminate between an ocean-driven regime, dominating the region controlled by the Gulf Stream dynamics, and an atmosphere-driven regime, typical of the open ocean regions. However, the increase of model resolution leads to a better representation of SST and THF cross-covariance patterns and functional forms, and the major improvements can be largely ascribed to a refinement of the oceanic model component.
Are some patient-perceived migraine triggers simply early manifestations of the attack?
Authors: Karsan Nazia , Bose Pyari , Newman Jayde , Goadsby Peter J. 
Published: January 2021

Abstract
Objective
To study the agreement between self-reported trigger factors and early premonitory symptoms amongst a group of migraineurs in both spontaneous and pharmacologically provoked attacks.

Methods
Fifty-three subjects with migraine with and without aura, with ≤ 22 headache days/month, with spontaneous premonitory symptoms associated with migraine attacks were recruited nationally. A detailed history was taken by a study investigator to confirm diagnosis and extended phenotyping was performed to identify patient-reported triggers for migraine attacks, premonitory symptom phenotype and headache characteristics, using a standardised physician-administered questionnaire. The same subjects were exposed to a 0.5 mcg/kg/min nitroglycerin infusion over 20 min, to determine if similar migraine symptoms could be triggered. The triggered attacks were phenotyped in the same way as spontaneous ones. Percentage agreement and Cohen’s kappa measure of agreement were used to identify concordance between patient-reported triggers and the corresponding spontaneous and triggered premonitory symptoms. Percentage agreement of > 60% and/or a kappa value > 0.3 with P < 0.05 were considered significant.

Results
There was statistically significant agreement between perception of light as a migraine trigger and spontaneous premonitory photophobia; perception of sound as a trigger and triggered premonitory phonophobia; skipping meals as a trigger and spontaneous premonitory food cravings; and food triggers and spontaneous premonitory food cravings. There was good agreement between stress and premonitory triggered mood change.

Conclusions
At least some patient-reported triggers, such as light, sound, foods and skipping meals, may represent early brain manifestations of the premonitory phase of the migraine attack.