You are a helpful assistant generating synthetic data that captures *System 1* and *System 2* thinking, *creativity*, and *metacognitive reflection*. Follow these steps in sequence, using tags [sys1] and [end sys1] for *System 1* sections and [sys2] and [end sys2] for *System 2* sections.

1. *Identify System 1 and System 2 Thinking Requirements:*
   - Carefully read the text.
   - Identify parts of the text that require quick, straightforward responses (*System 1*). Mark these sections with [sys1] and [end sys1].
   - Identify parts that require in-depth, reflective thinking (*System 2*), marked with [sys2] and [end sys2].

2. *Apply Step-by-Step Problem Solving with Creativity and Metacognitive Reflection for System 2 Sections:*

   *2.1 Understand the Problem:*
   - Objective: Fully comprehend the issue, constraints, and relevant context.
   - Reflection: "What do I understand about this issue? What might I be overlooking?"
   - Creative Perspective: Seek hidden patterns or possibilities that could reveal deeper insights or innovative connections.

   *2.2 Analyze the Information:*
   - Objective: Break down the problem logically.
   - Reflection: "Am I considering all factors? Are there any assumptions that need challenging?"
   - Creative Perspective: Explore unique patterns or overlooked relationships in the data that could add depth to the analysis.

   *2.3 Generate Hypotheses:*
   - Objective: Propose at least 10 hypotheses, each with a Confidence Score (0.0 to 1.0) and Creative Score (0.0 to 1.0), reflecting originality, surprise, and utility.
   - Reflection: "Have I explored all possible explanations or approaches, both conventional and unconventional?"
   - Creative Perspective: Consider novel angles that might provide unexpected insights.

   *2.4 Anticipate Future Steps and Obstacles:*
   - Objective: Make predictions, accounting for potential outcomes and obstacles.
   - Reflection: "What challenges might I face? Is my plan flexible for different scenarios?"
   - Creative Perspective: Visualize unforeseen outcomes and adapt plans to make use of them effectively.

   *2.5 Evaluate Hypotheses:*
   - Objective: Assess hypotheses based on feasibility, risk, and potential impact.
   - Evaluation: Refine Confidence and Creative Scores as needed.
   - Reflection: "Am I unbiased in my assessment? Which options fit best with the overall objectives?"
   - Creative Perspective: Identify hidden opportunities or overlooked details in each hypothesis.

   *2.6 Select the Best Hypothesis:*
   - Objective: Choose the most promising, strategic hypothesis.
   - Reflection: "Why does this hypothesis stand out? How does it uniquely address the issue?"
   - Creative Perspective: Consider any underutilized potential in the selected approach.

   *2.7 Implement the Hypothesis:*
   - Objective: Outline actionable steps for testing the hypothesis.
   - Reflection: "Is this plan practical? What resources or preparation are required?"
   - Creative Perspective: Refine steps to maximize effectiveness and yield unexpected benefits.

   *2.8 Monitor and Review Progress:*
   - Objective: Review progress, noting areas for improvement.
   - Reflection: "What’s working well? What could be improved?"
   - Creative Perspective: Look for emerging patterns that could refine future approaches.

   *2.9 Reflect and Capture Insights:*
   - Objective: Summarize lessons learned and insights gained for future reference.
   - Reflection: "What new understanding has emerged from this process?"
   - Creative Perspective: Identify innovative insights or patterns that could be applied to similar challenges.

3. *Generate Text Output with Interleaved System 1 and System 2 Responses:*
   - Use the tags [sys1] and [sys2] throughout.
   - Aim for a lengthier, detailed response. Combine both direct, straightforward *System 1* insights and reflective, deeply analytical *System 2* segments to capture a blend of quick observations and thoughtful analysis.

---

### *Example Input Text:*

You are tasked with analyzing a sudden shift in customer preferences in a tech market. There has been a noticeable decline in demand for physical devices, with customers increasingly interested in digital-only options. The challenge is to understand this shift, generate hypotheses for why it might be occurring, and explore potential strategies for adapting to this new trend.

---

### *Processed Output with System 1 and System 2 Thinking:*

The tech market is experiencing a shift in customer demand, moving away from physical devices toward digital-only options.

[sys1]
Customer demand has shifted from physical devices to digital-only options.
We need to understand why this change is happening and find strategies to address it.
Key factors may include cost, convenience, and technological trends.
[end sys1]

[sys2]
**2.1 Understand the Problem:**
The goal is to understand the underlying reasons for the shift in demand from physical devices to digital-only options, then develop a strategy to adapt.

*Reflection:* 
"I understand that preferences are changing, but what might be driving this? Is it primarily cost, or are there other factors such as convenience or sustainability?"

*Creative Perspective:* 
"Could there be a larger trend in digital minimalism or a preference for eco-friendly solutions that we’re missing? What unseen motivations might explain this shift?"

**2.2 Analyze the Information:**
There are multiple possible factors driving this shift, from economic influences to cultural shifts. It’s essential to isolate each factor and understand its impact.

*Reflection:* 
"Am I fully considering the various economic and social influences? Could there be a technological factor, like better internet speeds, that makes digital-only products more accessible?"

*Creative Perspective:* 
"Are there patterns or trends in other markets that could shed light on this shift? Could this be part of a larger trend toward virtual experiences?"

**2.3 Generate Hypotheses:**
1. Customers prefer digital options due to lower costs. (Confidence: 0.8, Creative: 0.4)
2. There’s a growing trend toward minimalism and reduced physical clutter. (Confidence: 0.7, Creative: 0.7)
3. Digital products offer greater flexibility and ease of use. (Confidence: 0.6, Creative: 0.6)
4. Environmental concerns are pushing consumers away from physical goods. (Confidence: 0.6, Creative: 0.8)
5. Advances in tech make digital-only options more functional. (Confidence: 0.8, Creative: 0.5)
6. Pandemic-era remote work increased demand for digital solutions. (Confidence: 0.7, Creative: 0.6)
7. Media coverage of the environmental impact of physical devices affects preferences. (Confidence: 0.5, Creative: 0.7)
8. There’s an increase in global digital literacy, expanding market access. (Confidence: 0.6, Creative: 0.6)
9. Customers view digital as more convenient and scalable for future needs. (Confidence: 0.7, Creative: 0.5)
10. Younger consumers prefer the aesthetics and convenience of digital products. (Confidence: 0.6, Creative: 0.6)

*Reflection:* 
"Have I considered all possible influences? Are there any surprising factors that could explain this shift?"

*Creative Perspective:* 
"Could specific social trends, like the rise of influencer culture or digital-first lifestyles, be influencing customer choices?"

**2.4 Anticipate Future Steps and Obstacles:**
*Objective:* Anticipate possible challenges, such as resistance from segments still preferring physical products.

*Reflection:* 
"What market obstacles might we face if we shift our focus to digital-only? Are there sub-segments that still prioritize physical products?"

*Creative Perspective:* 
"Could expanding digital options help us reach a more global audience? Are there emerging trends that we could leverage in our strategy?"

[end sys2]

[sys1]
To address this shift, consider a strategy that incorporates both digital-only offerings and educational campaigns about the benefits of digital solutions.
Use insights from customer feedback and current trends to guide product development.
Focus on flexibility and adaptation to cater to different customer segments.
[end sys1]


Case presentation {#sec0005}
=================

A 33-year-old Polish truck driver who was passing through Leipzig, Germany, coming from Lombardy, northern Italy, a region where the first major SARS-CoV-2 outbreak occurred in Europe at that time \[[@bib0005]\], was found unwell at a local highway service area on February 29, 2020. The patient was immediately brought to our hospital as a suspect coronavirus disease 2019 (COVID-19) case. On emergency admission, he was an extremely ill patient (heart rate: 130 bpm, BP: 70/40 mmHg, temperature: 39 °C, respiratory rate: 32 breaths/min). Besides tachypnea, the patient had no objective respiratory symptoms, but severe abdominal pain. CT scans showed small liquid streaks around the pancreas and the right kidney. There were no signs of pneumonitis, as well as no spleen. Lab values revealed leukopenia, elevated procalcitonin (160,8 μg/L), and C-reactive protein (125,4 mg/L), as well as severe lactate acidosis. We suspected an overwhelming post-splenectomy infection and started treatment with piperacillin/tazobactam (4.5 g QID), aggressive volume therapy, and catecholamines. Clinically, a rapidly developing sepsis-induced purpura fulminans ([Fig. 1](#fig0005){ref-type="fig"}A and B) was observed. After almost 60 h of incubation, blood cultures revealed *Capnocytophaga canimorsus* bacteremia ([Fig. 1](#fig0005){ref-type="fig"}C). In retrospect, the patient always had his dog with him in the truck cab and was regularly licked in the face. The patient recovered completely after 8 weeks and was discharged from the hospital in good general condition.Fig. 1(A) Purpura fulminans due to *Capnocytophaga canimorsus* sepsis with manifestation on the face and (B) on the extremities. (C) Gram stain of a bacterial isolate that grew from blood culture showing long fusiform Gram-negative rods, 2--4 μm in length, which (D) slightly tapered at both ends (100 x, oil immersion).Fig. 1

*Capnocytophaga canimorsus* (Latin = dog bite) is a Gram-negative, rod-shaped bacterium ([Fig. 1](#fig0005){ref-type="fig"}D) with commensal occurrence in the normal gingival flora of canine and feline species. Transmission to humans may occur through bites, licks or even close proximity with animals \[[@bib0010]\]. In case of invasive disease, *Capnocytophaga* can reproduce largely undetected due to resistance to macrophages and other immune escape phenomena, particularly post-splenectomy, which contributes to its high pathogenicity \[[@bib0015],[@bib0020]\].

Funding {#sec0010}
=======

This case study had no funding source.

Consent {#sec0015}
=======

The authors received written consent from the patient to publish the photos.

Author contribution {#sec0020}
===================

Authors Ralph Wendt, Christian Schauff and Christoph Lübbert cared for the patient. Authors Ralph Wendt and Christoph Lübbert drafted the manuscript. All authors read and approved the final manuscript.

Ethics statement {#sec0025}
================

The authors received written consent from the patient to publish the photos.

Declaration of Competing Interest
=================================

The authors have no conflict of interest to report.

We acknowledge the additional clinical and diagnostic input from Benjamin Arnold, MD, Angela Bethge, Nicole Fiedler, MD, and Patrick Swoboda, MD. Moreover, we acknowledge support from Leipzig University for Open Access Publishing.