bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the impact of the 2021 flood event on the archaeological heritage of the Rhineland (Germany)
Authors: Schmidt Isabell , Boemke Bruno , Herzog Irmela , Koppmann Claudia , Witte Hannah , Sauer Florian , Claßen Erich , Lehmkuhl Frank 
Published: September 2024

Abstract
Background
Archaeological sites are increasingly threatened by climate-related hazards. In response, heritage management authorities initiated projects to document damage and plan risk assessment measures. We present a project initiated after the heavy rainfall and subsequent flood event of July 2021, which involved extensive fieldwork to document the damage to archaeological sites in the Rhineland. We use this database to characterise and assess the damage and investigate site-specific and geospatial factors to identify potential predictive parameters for site damage.

Results
During fieldwork, we found that the flood damaged 19% of the 538 archaeological sites surveyed. The majority of damaged sites are relatively recent, dating from the medieval or modern periods, and are associated with the use of water power. Damage was mainly caused by erosion, floating debris and washout, e.g. mortar. In a case study, we tested the option of comparing pre- and post-disaster Airborne Laser Scanning elevation data to identify damages. It showed that not only the damage detected during fieldwork was found but also additional areas of loss. In general, however, and quantified based on the entire dataset, the ordnance survey Airborne Laser Scanning data were of limited use for monitoring flood-related damage and could not replace fieldwork. Our statistical analysis of possible risk factors, including both site characteristics and geospatial parameters, using Naïve Bayes Modelling and chi-squared tests, showed that no set of parameters could consistently predict the preservation or damage of archaeological sites across all catchments. In contrast, some external geospatial factors correlated with the occurrence of damage.

Conclusions
The study highlights both the strengths and limitations of the approaches used to assess and predict the damage to the archaeological heritage in the 2021 flood zones of the Rhineland. It also demonstrates the complexity of the data and spatial processes involved, which limits generalisation but can still inform decision-making for archaeological site management and on-site protection measures in flood-prone areas. With the prospect of more frequent heavy rainfall due to climate change, the specific needs of the archaeological heritage should be integrated into broader prevention and disaster management plans.
Gravitational change-induced alteration of the vestibular function and gene expression in the vestibular ganglion of mice
Authors: Bazek Murat , Sawa Motoya , Horii Kazuhiro , Nakamura Naotoshi , Iwami Shingo , Wu Chia-Hsien , Inoue Tsuyoshi , Nin Fumiaki , Abe Chikara 
Published: September 2024

AbstractGravity has profoundly influenced life on Earth, yet how organisms adapt to changes in gravity remains largely unknown. This study examines vestibular plasticity, specifically how the vestibular system responds to altered gravity. We subjected male C57BL/6J mice to hypergravity (2 G) followed by normal gravity (1 G) to analyze changes in vestibular function and gene expression. Mice showed significant vestibular dysfunction, assessed by righting reflex tests, which persisted for days but reversed at 1 G after exposure to 2 G. Gene expression analysis in the vestibular ganglion identified significant changes in 212 genes out of 49,585 due to gravitational changes. Specifically, 25 genes were upregulated under 2 G and recovered at 1 G after 2 G exposure, while one gene showed the opposite trend. Key neural function genes like Shisa3, Slc25a37, Ntn4, and Snca were involved. Our results reveal that hypergravity-induced vestibular dysfunction is reversible and highlight genes critical for adaptation.
Personalized sleep and nutritional strategies to combat adverse effects of night shift work: a controlled intervention protocol
Authors: van der Rhee Maaike , Oosterman Johanneke E. , Wopereis Suzan , van der Horst Gijsbertus T. J. , Chaves Inês , Dollé Martijn E. T. , Burdorf Alex , van Kerkhof Linda W. M. , der Holst Heidi M. Lammers-Van 
Published: September 2024

Abstract
Background
Working during the night interferes with the timing of normal daily activities and is associated with an increased risk of chronic diseases. Under controlled experimental conditions, interventions focusing on sleep and nutrition can mitigate the short-term adverse effects of shift work. However, it is unclear how these results translate to real-life, how they can be targeted to individual conditions, and how they relate to long-term health. Therefore, the current study aims to implement a personalized sleep and nutritional intervention among night shift workers in the field.

Methods
A non-blinded controlled intervention study is used, consisting of a run-in period, an intervention of 3 months, post-intervention measurements, and a follow-up after 12 months. Three study arms are included: sleep intervention, nutritional intervention, and control group (n = 25 each). Participants are healthy 18–60-year male night shift workers, with at least one year of experience in night shift work. Information from the run-in period will be used to personalize the interventions. The main outcomes are sleep measurements and continuous interstitial glucose levels. Furthermore, general health biomarkers and parameters will be determined to further evaluate effects on long-term health.

Discussion
This study aims to mitigate negative health consequences associated with night shift work by introducing two personalized preventive interventions. If proven effective, the personalized interventions may serve as practical solutions that can have a meaningful impact on the sustainable health and employability of night shift workers. This study will thereby contribute to the current need for high–quality data on preventative strategies for night shift work in a real-life context.

Trial registration
This trial has been registered under ClinicalTrials.gov Identifier NCT06147089. Registered 27 November 2023.
Examining gaze behavior in undergraduate students and educators during the evaluation of tooth preparation: an eye-tracking study
Authors: Silvestri Frédéric , Odisho Nabil , Kumar Abhishek , Grigoriadis Anastasios 
Published: September 2024

Abstract
Background
Gaze behavior can serve as an objective tool in undergraduate pre-clinical dental education, helping to identify key areas of interest and common pitfalls in the routine evaluation of tooth preparations. Therefore, this study aimed to investigate the gaze behavior of undergraduate dental students and dental educators while evaluating a single crown tooth preparation.

Methods
Thirty-five participants volunteered to participate in the study and were divided into a novice group (dental students, n = 18) and an expert group (dental educators, n = 17). Each participant wore a binocular eye-tracking device, and the total duration of fixation was evaluated as a metric to study the gaze behavior. Sixty photographs of twenty different tooth preparations in three different views (buccal, lingual, and occlusal) were prepared and displayed during the experimental session. The participants were asked to rate the tooth preparations on a 100 mm visual analog rating scale and were also asked to determine whether each tooth preparation was ready to make an impression. Each view was divided into different areas of interest. Statistical analysis was performed with a three-way analysis of the variance model with repeated measures.

Results
Based on the participants’ mean rates, the “best” and the “worst” tooth preparations were selected for analysis. The results showed a significantly longer time to decision in the novices compared to the experts (P = 0.003) and a significantly longer time to decision for both the groups in the best tooth preparation compared to the worst tooth preparation (P = 0.002). Statistical analysis also showed a significantly longer total duration of fixations in the margin compared to all other conditions for both the buccal (P < 0.012) and lingual (P < 0.001) views.

Conclusions
The current study showed distinct differences in gaze behavior between the novices and the experts during the evaluation of single crown tooth preparation. Understanding differences in gaze behavior between undergraduate dental students and dental educators could help improve tooth preparation skills and provide constructive customized feedback.
Lasting effects of transcranial direct current stimulation on the inducibility of synaptic plasticity by paired-associative stimulation in humans
Authors: Vestring Stefan , Wolf Elias , Dinkelacker Johanna , Frase Sibylle , Hessling-Zeinen Carolin , Insan Shrabon , Kumlehn Maral M. , Feige Bernd , Domschke Katharina , Normann Claus , Frase Lukas 
Published: September 2024

Abstract
Background
Transcranial direct current stimulation (tDCS) is capable of eliciting changes in cortical neuroplasticity. Increasing duration or repetition of tDCS during the after-effects of a first stimulation has been hypothesized to enhance efficacy. Computational models suggest sequential stimulation patterns with changing polarities to further enhance effects. Lasting tDCS effects on neural plasticity are of great importance for clinical applications.

Objective
The study systematically examined the influence of different tDCS paradigms on long term potentiation (LTP)-like plasticity in humans, focusing on stimulation duration, repetition frequency and sequential combinations of changing polarities as the underlying characteristics.

Methods
Amplitude changes of motor evoked potentials (MEP) were measured in response to paired associative stimulation (PAS) 6 h after application of different tDCS protocols. In total, 36 healthy participants completed the study, randomised into three groups with different stimulation protocols (N = 12 each).

Results
tDCS was able to display lasting modulatory effects on the inducibility of LTP-like plasticity in the human motor cortex 6 h after stimulation. TDCS with the anode on primary motor cortex significantly increased MEP amplitudes following PAS induction. Further analyses highlighted single stimulation block duration to be of higher importance than repetitive protocols for efficacy of effects.

Conclusions
tDCS is capable of inducing lasting changes in the brain’s capability to interact with future stimuli. Especially, effects on the inducibility of LTP-like plasticity might only be detectable with specific tests such as PAS and might otherwise be overlooked. Refined tDCS protocols should focus on higher current and duration of single stimulations instead of implementing complex repetitive schedules.
Clinical and genetic characteristics of 100 consecutive patients with Birt-Hogg-Dubé syndrome in Eastern Chinese region
Authors: Hu Daiju , Wang Rui , Liu Jinli , Chen Xianmeng , Jiang Xianliang , Xiao Jun , Ryu Jay H. , Hu Xiaowen 
Published: September 2024

Abstract
Background
Although an increasing number of patients with Birt-Hogg-Dubé syndrome (BHD) are being recognized in China, clinical and genetic characteristics are not well-defined. In addition, revised diagnostic criteria for the Chinese population was proposed in 2023, we aimed to explore their utility in clinical practice at a rare lung disease center.

Methods
We retrospectively analyzed the data of 100 consecutive patients with BHD diagnosed according to the revised Chinese BHD criteria, encountered at the First Affiliated Hospital of University of Science and Technology of China from Jan 2017 to June 2023.

Results
There were 100 patients (including 63 females) from 65 unrelated families in Eastern China, mostly Anhui Province. The common manifestations were pulmonary cysts (99%), pneumothorax (60%), and skin lesions (77%). Renal cancer and renal angiomyolipoma were detected in 5 patients each. 37% of patients had no family history of BHD. In total, 25 FLCN germline mutations were detected, including 6 novel mutations. In addition to hotspot mutation c.1285delC/dupC (17%), the most common mutations were c.1015 C > T (16%), c.1579_1580insA (14%), and exons 1–3 deletion (11%) in FLCN. Higher risk of pneumothorax was associated with exons 1–3 deletion mutation and c.1177-5_1177-3de1CTC compared to the hotspot mutation c.1285dupC (91% [95% CI: 0.31, 46.82, p = 0.015] and 67% [95% CI: 0.35, 71.9, p = 0.302] vs. 30%, respectively). The average delay in diagnosis was 7.6 years after initial symptoms. Chinese diagnostic criteria were mostly consistent with typical pulmonary presentations with supportive genetic evidence.

Conclusion
In the Eastern Chinese region, patients with BHD present most commonly with pulmonary cysts associated with pneumothorax and skin lesions. However, low incidence of renal cancer along with unexpected renal angiomyolipoma was observed. Genotypic spectrum differed from that reported from other global regions, and genotype association of pneumothorax warrants further research. The revised Chinese criteria for BHD seem more appropriate in diagnosing BHD in Chinese patients.
Patients' use of Danish emergency medical services before and during the COVID-19 pandemic: a register-based study
Authors: Lindskou Tim Alex , Bogh Søren Bie , Kløjgaard Torben Anders , Fløjstrup Marianne , Folke Fredrik , Væggemose Ulla , Christensen Helle Collatz , Christensen Erika Frischknecht , Brabrand Mikkel , Mikkelsen Søren 
Published: September 2024

Abstract
Background
During the COVID-19 pandemic, disturbing images of ambulances unable to respond to the demands for prehospital assistance appeared from several parts of the world. In Denmark, however, a notion occurred that the demands for emergency medical assistance declined. The purpose of this study was to compare the patients' use of the Danish Emergency Medical Services (EMS) before and during the COVID-19 pandemic. Furthermore, we investigated the overall mortality of the ambulance population, the main reason for calling the emergency medical dispatch centre, and the diagnosis assigned to the admitted patients.

Methods
The study was a nationwide registry-based cohort study based on the national prehospital medical records and the Danish National Patient Registry. The primary outcome was the requested number of ambulances. Secondary outcomes included the primary reason for contact with the dispatch centre (reflected by the dispatch criteria), patient mortality, and the diagnoses assigned to the patients transported to the hospital by ambulance during the COVID-19 pandemic in Denmark in March–December 2020. Comparisons were made using a similar period in 2019 before the pandemic.

Results
In comparison with the baseline values before the pandemic, the total number of patients treated by the EMS was reduced by 4.5% during the COVID-19 pandemic. The number of patients transported to the hospital during the pandemic was similarly reduced by 3.5%. Compared with baseline values, fewer were patients hospitalised with respiratory diseases during the pandemic (a reduction of 53.3% from April 2019 to April 2020).
Compared to the baseline period, there were significant increases in both the 48-h mortality (from 1.4% to 1.5%) and the 30-day mortality (from 4.9% to 5.4%) (p < 0.03 and p < 0.001, respectively), in patients hospitalised during the pandemic.

Conclusion
During the first wave of the COVID-19 pandemic, the Danish EMS experienced an overall reduction in the requests for and the use of ambulances and, especially, in the number of patients admitted to hospitals for respiratory diseases. Despite the overall reduction in EMS requests, the mortality of the ambulance population increased, indicating that despite the reduced ambulance use, the prehospital population was more severely ill during the pandemic.
Effects of hippotherapy on motor function of children with cerebral palsy: a systematic review study
Authors: Plotas Panagiotis , Papadopoulos Angelos , Apostolelli Evangelia-Maria , Vlachou Eleni , Gazou Foteini , Zogopoulou Ioanna , Katsaidoni Ioanna , Panagiotopoulou Ioanna , Paparouna Sofia Paraskevi , Silavou Nikolina , Fragkiadaki Katerina , Tsiamaki Eirini , Fouzas Sotirios , Sinopidis Xenophon , Trimmis Nikolaos 
Published: September 2024

AbstractCerebral palsy includes a spectrum of neurodevelopmental disorders caused by brain damage, leading to impairment of movement, posture, and balance for a lifetime. There are many therapeutic interventions for cerebral palsy. One of them is hippotherapy, an alternative physical therapy. It is a type of equine-assisted activity and therapy where children with cerebral palsy and motor function skills interact with a horse. We aimed to study the effects of hippotherapy, as an alternative therapy, on the motor function of children with cerebral palsy. We performed a review of the latest literature on hippotherapy and cerebral palsy. The criteria we used were specific keywords, publication date, age of the subjects/studied population, and article type. The outcome of our research resulted in ten relevant studies. The findings demonstrate improvements in various aspects of motor function – more specifically in gross motor function skills, balance, coordination, gait parameters, and muscle strength. Two of ten studies used the Horse-Riding Simulator with significant improvements in postural control in sitting, motor function, and hip abduction range of motion. Hippotherapy can improve motor function skills of children between 2 and 14 years of age with cerebral palsy, affecting their well-being and overall quality of life. It can have a positive effect either as a standalone treatment or as a part of other traditional therapies. Extended research is needed to assess whether hippotherapy may present significant long-term changes in motor skills in children with cerebral palsy.
Neonatal birth asphyxia and associated factors among newborns delivered and admitted to NICU in selected public hospitals, under Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia, A cross-sectional study
Authors: Tarko Dawit , Zewdu Tesfu , Tesfaye Shewamene , Gerezihear Abel , Haile Azeb 
Published: September 2024

Abstract
Background
In developing countries birth asphyxia is a major cause of neonatal morbidity and mortality. Despite the implementation of various strategies and interventions to combat neonatal mortality rates, birth asphyxia remains the main public health concern in Ethiopia. Moreover, limited studies have been conducted, especially in the study area and there are no multicenter analyses available to generate evidence for action. Therefore, this study aimed to assess the burden and associated factors of birth asphyxia among newborns in the selected public hospitals of the Addis Ababa City Administration Health Bureau.

Methods
Three hundred forty-three mother-child pairs who used delivery services and gave birth in the selected public hospitals were included in the study, and institution based cross sectional study design was employed. A systematic random sampling technique was used to select the study participants. A pretested, structured interviewer administered questionnaire was used to collect the data. The physician’s/health care professionals diagnosis of an Apgar score less than 7 within the first five minutes of life led to the confirmation of the diagnosis of birth asphyxia. SPSS version 24 was used for analysis after the data were exported from Epi Info version 7.2. Multivariate logistic regression analysis included variables which had P-values less than 0.25 in the bivariable logistic regression analysis. The study findings were expressed using adjusted odds ratio with a 95% confidence interval, and P-value less than 0.05 was used to declare the statistical significance.

Results
The magnitude of birth asphyxia was found to be 17.1% [95% CI; (13.2–21.5)] at the first 5 min. In the multivariable logistic regression analysis cord accident [AOR = 6.24: 95% CI; (1.24–31.32)], prolonged duration of labor [AOR = 2.49: 95% CI; (1.93–10.89)], and meconium-stained amniotic fluid [AOR = 3.33: 95% CI; (1.73–6.41)] were the predictors of birth asphyxia.

Conclusions
The findings of this research indicate that birth asphyxia is a prevalent neonatal problem at the study area. Therefore, the Addis Ababa Health Bureau must prioritize integrated mitigation interventions targeting high-risk pregnancies to achieve national and international commitment to sustainable changes in newborn health.
Association between subcortical nuclei volume changes and cognition in preschool-aged children with tetralogy of Fallot after corrective surgery: a cross-sectional study
Authors: Hu Liang , Wu Kede , Li Huijun , Zhu Meijiao , Zhang Yaqi , Fu Mingcui , Tang Minghui , Lu Fan , Cai Xinyu , An Jia , Patel Nishant , Lin Ye , Zhang Zhen , Yang Ming , Mo Xuming 
Published: September 2024

Abstract
Background
Neurocognitive disorders frequently occur in patients with cyanotic congenital heart disease (CCHD) because of the hemodynamic abnormalities induced by preoperative cardiac structural changes. We aimed to evaluate subcortical nuclei volume changes and cognition in postoperative tetralogy of Fallot (TOF) children, and analyze their relationship with preoperative cardiac structural changes.

Methods
This case-control study involved thirty-six children with repaired TOF and twenty-nine healthy controls (HCs). We utilized three-dimensional (3D) T1-weighted high-resolution structural images alongside the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV) to evaluate the cognitive differences between the TOF and HC group.

Results
We observed notable differences in subcortical nuclei volume between the TOF and HC group, specifically in the left amygdala nucleus (LAM, TOF: 1292.60 ± 155.57; HC: 1436.27 ± 140.62, p < 0.001), left thalamus proper nucleus (LTHA, TOF: 6771.54 ± 666.03; HC: 7435.36 ± 532.84, p < 0.001), and right thalamus proper nucleus (RTHA, TOF: 6514.61 ± 715.23; HC: 7162.94 ± 554.60, p < 0.001). Furthermore, a diminished integrity of LAM ( β:-19.828, 95% CI: -36.462, -3.193), which showed an inverse relationship with the size of the preoperative ventricular septal defect (VSD), correlated with lower working memory indices in children with TOF.

Conclusions
Our findings indicate that subcortical nuclei structural injuries possibly potentially stemming from cardiac anatomical abnormalities, are associated with impaired working memory in preschool-aged children with TOF. The LAM in particular may serve as a potential biomarker for neurocognitive deficits in TOF, offering predictive value for future neurodevelopmental outcomes, and shedding light on the neurophysiological mechanisms of these cognitive impairments.