bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Wilson disease in Germany – real-world insights from a claims data study
Authors: Fang Shona , Hedera Peter , Borchert Julia , Schultze Michael , Weiss Karl Heinz 
Published: September 2024

Abstract
Background
Wilson disease (WD) is a rare disorder of copper metabolism, causing copper accumulation mainly in the liver and the brain. The prevalence of WD was previously estimated around 20 to 33.3 patients per million for the United States, Europe, and Asia, but data on the prevalence of WD in Germany are limited.

Objectives
To describe patient characteristics and to assess prevalence of WD in Germany using a representative claims database.

Methods
WD patients were identified in the WIG2 (Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung; Scientific Institute for Health Economics and Health Systems Research) benchmark database of 4.5 million insured Germans by combining ICD-10-coding with WD-specific lab tests and treatments. The study period ranged from 2013 to 2016 for assessing patient characteristics, and to 2018 for prevalence, respectively.

Results
Seventy unique patients were identified. Most patients (86%) were between 18 and 64 years of age and more often male (60%) than female. Two patients (3%) younger than 18 years were included, as well as 8 patients (11%) older than 64 years. Most common WD subtypes were hepatic (57%), psychiatric (49%), and neurologic (44%). Average prevalence was 20.3 patients per million (range: 17.8–24.4), with similar results for two-year prevalence. Generally, prevalence increased steadily over the study period. Observed mortality was low, with only one death during the study period.

Conclusions
This study adds valuable real-world data on the prevalence and patient characteristics of WD in Germany. Generally, our findings align with other reports and contribute to the global understanding of WD epidemiology. Still, regional and temporal trends remain to be investigated more thoroughly to further the understanding of the natural history and epidemiology of this rare disease.
Real-time PCR for malaria diagnosis and identification of Plasmodium species in febrile patients in Cubal, Angola
Authors: Mediavilla Alejandro , Silgado Aroa , Febrer-Sendra Begoña , Crego-Vicente Beatriz , Martínez-Vallejo Patricia , Maturana Carles Rubio , Goterris Lidia , Nindia Arlette , Martínez-Campreciós Joan , Aixut Sandra , Aznar-Ruiz-de-Alegría María Luisa , Fernández-Soto Pedro , Muro Antonio , Salvador Fernando , Molina Israel , Berzosa Pedro , Oliveira-Souto Inés , Sulleiro Elena 
Published: September 2024

Abstract
Background
Malaria is the parasitic disease with the highest morbimortality worldwide. The World Health Organization (WHO) estimates that there were approximately 249 million cases in 2022, of which 3.4% were in Angola. Diagnosis is based on parasite identification by microscopy examination, antigen detection, and/or molecular tests, such as polymerase chain reaction (PCR). This study aimed to evaluate the usefulness of real-time PCR as a diagnostic method for malaria in an endemic area (Cubal, Angola).

Methods
A cross-sectional study was carried out at the Hospital Nossa Senhora da Paz in Cubal, Angola, including 200 patients who consulted for febrile syndrome between May and July 2022. From each patient, a capillary blood sample was obtained by finger prick for malaria field diagnosis [microscopy and rapid diagnostic test (RDT)] and venous blood sample for real-time PCR performed at the Hospital Universitario Vall d’Hebron in Barcelona, Spain. Any participant with a positive result from at least one of these three methods was diagnosed with malaria.

Results
Of the 200 participants included, 54% were female and the median age was 7 years. Malaria was diagnosed by at least one of the three techniques (microscopy, RDT, and/or real-time PCR) in 58% of the participants, with RDT having the highest percentage of positivity (49%), followed by real-time PCR (39.5%) and microscopy (33.5%). Of the 61 discordant samples, 4 were only positive by microscopy, 13 by real-time PCR, and 26 by RDT. Plasmodium falciparum was the most frequent species detected (90.63%), followed by P. malariae (17.19%) and P. ovale (9.38%). Coinfections were detected in ten participants (15.63%): six (60%) were caused by P. falciparum and P. malariae, three (30%) by P. falciparum and P. ovale, and one (10%) triple infection with these three species. In addition, it was observed that P. falciparum and P. malariae coinfection significantly increased the parasite density of the latter.

Conclusions
RDT was the technique with the highest positivity rate, followed by real-time PCR and microscopy. The results of the real-time PCR may have been underestimated due to suboptimal storage conditions during the transportation of the DNA eluates. However, real-time PCR techniques have an important role in the surveillance of circulating Plasmodium species, given the epidemiological importance of the increase in non-falciparum species in the country, and can provide an estimate of the intensity of infection.

Graphical abstract
Continued decitabine/all-trans retinoic acid treatment: extended complete remission in an elderly AML patient with multi-hit TP53 lesions and complex-monosomal karyotype
Authors: Thomas Johanna , Rehman Usama-Ur , Bresser Helena , Grishina Olga , Pfeifer Dietmar , Sollier Etienne , Döhner Konstanze , Plass Christoph , Becker Heiko , Schmoor Claudia , de Wit Maike , Lübbert Michael 
Published: September 2024

AbstractDNA-hypomethylating agents (HMAs) induce notable remission rates in AML/MDS patients withTP53mutations; however, secondary resistance often develops rapidly. In the DECIDER trial (NCT00867672), elderly AML patients (also those with adverse genetics) randomized to all-transretinoic acid (ATRA) added to decitabine (DEC) attained significantly delayed time-to-resistance. An 82-year-old patient with a non-disruptive, in-frameTP53mutation (p.Cys238_Asn239delinsTyr, VAF 90%) and complex-monosomal karyotype attained a complete hematologic and cytogenetic remission with DEC + ATRA, with 3.7 years survival after 30 treatment cycles that were well-tolerated. Further HMA + ATRA studies appear warranted in AML/MDS patients of different genetic risk groups ineligible for more intensive treatment.Trial registration: This trial was registered at ClinicalTrials.gov identifier: NCT00867672
A redescription of Brouffia orientalis Carroll & Baird, 1972 from the Upper Carboniferous of the Czech Republic and the status and affinities of protorothyridid amniotes
Authors: Klembara Jozef , Ruta Marcello , Anderson Jason , Mayer Taran , Hain Miroslav , Valaška Daniel 
Published: September 2024

AbstractThe Upper Carboniferous protorothyridid amniote Brouffia orientalis from Czech Republic is redescribed. Photogrammetric scanning of the holotype and only known specimen yields considerable new information on the skull and postcranium of this tetrapod and allows us to amend previous morphological descriptions to a substantial degree. A virtual 3D model built from photogrammetry scan data is used as the basis for a new reconstruction of the skull in dorsal, lateral, and ventral aspects and the lower jaw in lateral aspect. We expand and refine the diagnosis of Brouffia and compare it with other protorothyridids. We discuss the affinities of this taxon by coding it in a recently published data matrix of early amniotes, which we subject to maximum parsimony and Bayesian fossilized birth–death analyses. Brouffia emerges as the sister taxon to Coelostegus in all analyses, but the position of these two taxa within amniotes varies. In a parsimony analysis with unweighted characters, the (Brouffia + Coelostegus) clade forms the sister group to Synapsida. In various experiments of character reweighting, that clade is placed crownward of Captorhinidae on the stem-group of Reptilia, but anticrownward of remaining protorothyridids. The latter constitute either a paraphyletic array relative to Diapsida or their monophyletic sister group. The Bayesian analysis retrieves (Brouffia + Coelostegus) as the most basal plesion on the stem-group of Reptilia.
Peripheral perfusion index of pulse oximetry in adult patients: a narrative review
Authors: Sun Xiaotong , He Huaiwu , Xu Mengru , Long Yun 
Published: September 2024

AbstractThe peripheral perfusion index (PI) is derived from pulse oximetry and is defined as the ratio of the pulse wave of the pulsatile portion (arteries) to the non-pulsatile portion (venous and other tissues). A growing number of clinical studies have supported the use of PI in various clinical scenarios, such as guiding hemodynamic management and serving as an indicator of outcome and organ function. In this review, we will introduce and discuss this traditional but neglected indicator of the peripheral microcirculatory perfusion. Further clinical trials are required to clarify the normal and critical values of PI for different monitoring devices in various clinical conditions, to establish different standards of PI-guided strategies, and to determine the effect of PI-guided therapy on outcome.
Adapting EFL materials and its influences on Indonesia secondary school students’ language learning
Authors: Hanifa Rizaldy , Yusuf Fazri Nur , Yusra Siti Rahimah , Suherdi Didi 
Published: September 2024

AbstractEducators encounter challenges in performing materials adaptation stemming from time limitations, institutional responsibilities, administrative demands, and a dearth of formal training in materials development resulting in improper adaptation and ineffective learning activities. This research investigated the process of adapting materials as a qualitative case study. The data were gathered from a senior high school teacher in Banda Aceh, Indonesia, by means of document analysis (e.g., teaching materials), observation, and interview. The results revealed that the instructor frequently added and modified educational resources to facilitate learning through several modalities. The act of deleting, simplifying, and rearranging was occasionally performed. Nevertheless, students’ reflection on course contents, inadequate level of difficulty, demanding tasks, and excessive reliance on first language remained as issues. This study emphasizes the role of adaptation in promoting meaningful learning experiences and urges the integration of culturally relevant themes with a variety of learning activities. Educators can use these findings to support professional developments focused on effective material adaption tactics, allowing them to reflect on their existing methods, try new approaches, and interact with colleagues to share successful practices.
TEAMs go VR—validating the TEAM in a virtual reality (VR) medical team training
Authors: Wespi Rafael , Schwendimann Lukas , Neher Andrea , Birrenbach Tanja , Schauber Stefan K. , Manser Tanja , Sauter Thomas C. , Kämmer Juliane E. 
Published: September 2024

Abstract
Background
Inadequate collaboration in healthcare can lead to medical errors, highlighting the importance of interdisciplinary teamwork training. Virtual reality (VR) simulation-based training presents a promising, cost-effective approach. This study evaluates the effectiveness of the Team Emergency Assessment Measure (TEAM) for assessing healthcare student teams in VR environments to improve training methodologies.

Methods
Forty-two medical and nursing students participated in a VR-based neurological emergency scenario as part of an interprofessional team training program. Their performances were assessed using a modified TEAM tool by two trained coders. Reliability, internal consistency, and concurrent validity of the tool were evaluated using intraclass correlation coefficients (ICC) and Cronbach’s alpha.

Results
Rater agreement on TEAM’s leadership, teamwork, and task management domains was high, with ICC values between 0.75 and 0.90. Leadership demonstrated strong internal consistency (Cronbach’s alpha = 0.90), while teamwork and task management showed moderate to acceptable consistency (alpha = 0.78 and 0.72, respectively). Overall, the TEAM tool exhibited high internal consistency (alpha = 0.89) and strong concurrent validity with significant correlations to global performance ratings.

Conclusion
The TEAM tool proved to be a reliable and valid instrument for evaluating team dynamics in VR-based training scenarios. This study highlights VR’s potential in enhancing medical education, especially in remote or distanced learning contexts. It demonstrates a dependable approach for team performance assessment, adding value to VR-based medical training. These findings pave the way for more effective, accessible interdisciplinary team assessments, contributing significantly to the advancement of medical education.
Reclaiming identities: exploring the influence of simulation on refugee doctors’ workforce integration
Authors: Smith Samantha Eve , Tallentire Victoria Ruth , Doverty Julie , Elaibaid Mohamed , Mardon Julie , Livingston Patricia 
Published: September 2024

AbstractBackgroundHealthcare professionals are a precious resource, however, if they fail to integrate into the workforce, they are likely to relocate. Refugee doctors face workforce integration challenges including differences in language and culture, educational background, reduced confidence, and sense of identity. It has been proposed that simulation programmes may have the power to influence workforce integration. This study aimed to explore how an immersive simulation programme influenced workforce integration for refugee doctors joining a new healthcare system.MethodsDoctors were referred to a six-day immersive simulation programme by a refugee doctor charity. Following the simulation programme, they were invited to participate in the study. Semi-structured interviews, based on the ‘pillars’ conceptual model of workforce integration, were undertaken. Data were analysed using template analysis, with the workforce integration conceptual model forming the initial coding template. Themes and sub-themes were modified according to the data, and new codes were constructed. Data were presented as an elaborated pillars model, exploring the relationship between simulation and workforce integration.ResultsFourteen doctors participated. The ‘learning pillar’ comprised communication, culture, clinical skills and knowledge, healthcare systems and assessment, with a new sub-theme of role expectations. The ‘connecting pillar’ comprised bonds and bridges, which were strengthened by the simulation programme. The ‘being pillar’ encompassed the reclaiming of the doctor’s identity and the formation of a new social identity as an international medical graduate. Simulation opportunities sometimes provided ‘building blocks’ for the pillars, but at other times opportunities were missed. There was also an example of the simulation programme threatening one of the integration pillars.ConclusionsOpportunities provided within simulation programmes may help refugee doctors form social connections and aid learning in a variety of domains. Learning, social connections, and skills application in simulation may help doctors to reclaim their professional identities, and forge new identities as international medical graduates. Fundamentally, simulation experiences allow newcomers to understand what is expected of them. These processes are key to successful workforce integration. The simulation community should be curious about the potential of simulation experiences to influence integration, whilst also considering the possibility of unintentional ‘othering’ between faculty and participants.
Efficacy and safety of long-term treatment with elobixibat in hemodialysis patients with chronic constipation: an observational study
Authors: Shono Takefumi , Hyakutake Hiroyuki 
Published: September 2024

Abstract
Background
Constipation is a common complication in hemodialysis patients and can impact their quality of life. Elobixibat selectively inhibits ileal bile acid transporter to suppress bile acid reabsorption, increase the amount of bile acid entering the colonic lumen, and promote water secretion and colonic motility in the large intestine. While the efficacy and safety of elobixibat in hemodialysis patients up to 12 weeks after administration have been reported, the long-term efficacy and safety of elobixibat in hemodialysis patients with chronic constipation are yet to be elucidated. This study evaluates the efficacy and safety of long-term treatment with elobixibat in hemodialysis patients with chronic constipation.

Methods
This was a single-center observational study. A total of 54 patients who had received elobixibat for at least 24 weeks were enrolled. Data on the frequency of spontaneous bowel movements (SBM), Bristol stool form scale (BSFS), patient satisfaction, constipation scoring system (CSS), interdialytic weight gain, laboratory values including blood electrolyte levels, controlling nutritional status (CONUT) score, and adverse events were collected and retrospectively compared between baseline and the last observation.

Results
Long-term elobixibat treatment in the 54 hemodialysis patients with chronic constipation significantly increased (p < 0.05) the frequency of SBM and mean stool form score assessed as per the BSFS at the last observation (duration of treatment, 24.4 to 240.0 weeks). Patient satisfaction and CSS also improved (p < 0.05). Mean serum phosphorus levels decreased (p < 0.05). The treatment was well tolerated.

Conclusions
Long-term treatment with elobixibat maintained good bowel movement status and patient satisfaction in hemodialysis patients with chronic constipation. Improved dialysis-related laboratory levels were also demonstrated.
Trial registration: UMIN Clinical Trials Registry, UMIN000049865, 22 December 2022, retrospectively registered.
Audiovisual messages may improve the processing of traffic information and driver attention during partially automated driving: An EEG study
Authors: Pi-Ruano Marina , Fort Alexandra , Tejero Pilar , Jallais Christophe , Roca Javier 
Published: September 2024

AbstractPartially autonomous vehicles can help minimize human errors. However, being free from some driving subtasks can result in a low vigilance state, which can affect the driver’s attention towards the road. The present study first tested whether drivers of partially autonomous vehicles would benefit from the addition of auditory versions of the messages presented in variable message signs (VMS), particularly, when they find themselves in a monotonous driving situation. A second aim was to test whether the addition of auditory messages would also produce an indirect effect on the driver’s vigilance, improving performance on other driving subtasks not related to the message processing. Forty-three volunteers participated in a driving simulator study. They completed two tasks: (a) a VMS task, where they had to regain manual control of the car if the VMS message was critical, and (b) a car-following task, where they had to pay attention to the preceding car to respond to occasional brake events. Behavioral and EEG data were registered. Overall, results indicated that the addition of audio messages helped drivers process VMS information more effectively and maintain a higher level of vigilance throughout the driving time. These findings would provide useful information for the development of partially automated vehicles, as their design must guarantee that the driver remains attentive enough to assume control when necessary.
Reliable but multi-dimensional cognitive demand in operating partially automated vehicles: implications for real-world automation research
Authors: Lohani Monika , Cooper Joel M. , McDonnell Amy S. , Erickson Gus G. , Simmons Trent G. , Carriero Amanda E. , Crabtree Kaedyn W. , Strayer David L. 
Published: September 2024

AbstractThe reliability of cognitive demand measures in controlled laboratory settings is well-documented; however, limited research has directly established their stability under real-life and high-stakes conditions, such as operating automated technology on actual highways. Partially automated vehicles have advanced to become an everyday mode of transportation, and research on driving these advanced vehicles requires reliable tools for evaluating the cognitive demand on motorists to sustain optimal engagement in the driving process. This study examined the reliability of five cognitive demand measures, while participants operated partially automated vehicles on real roads across four occasions. Seventy-one participants (aged 18–64 years) drove on actual highways while their heart rate, heart rate variability, electroencephalogram (EEG) alpha power, and behavioral performance on the Detection Response Task were measured simultaneously. Findings revealed that EEG alpha power had excellent test–retest reliability, heart rate and its variability were good, and Detection Response Task reaction time and hit-rate had moderate reliabilities. Thus, the current study addresses concerns regarding the reliability of these measures in assessing cognitive demand in real-world automation research, as acceptable test–retest reliabilities were found across all measures for drivers across occasions. Despite the high reliability of each measure, low intercorrelations among measures were observed, and internal consistency was better when cognitive demand was estimated as a multi-factorial construct. This suggests that they tap into different aspects of cognitive demand while operating automation in real life. The findings highlight that a combination of psychophysiological and behavioral methods can reliably capture multi-faceted cognitive demand in real-world automation research.
Analysis of predictors of hemorrhagic transformation after reperfusion therapy with recombinant tissue plasminogen activator in patients with acute ischemic stroke: a single-center experience
Authors: Nassar Mahmoud H. , Elrefaey Amany F. , Abbas Khalil M. , Mohamed Ehab S. , Ragab Osama A. 
Published: September 2024

Abstract
Background
Hemorrhagic transformation (HT) is a serious complication of thrombolytic therapy for acute ischemic stroke, limiting its indications and affecting treatment plans and clinical prognosis. Identifying risk factors for HT could help improve the risk–benefit ratio of thrombolytic therapy. We aimed to analyze the predictors of HT after reperfusion therapy with recombinant tissue plasminogen activator (rTPA) in patients with acute ischemic stroke. This study included 115 patients who received rTPA. All patients underwent history taking, clinical examination, neurological examination including Glasgow Coma Scale and National Institutes of Health Stroke Scale scores (NIHSS), radiological investigation, and cardiac investigation. Patients were followed up strictly every 2 h for 1st 24 h then for two weeks clinically using the NIHSS and radiologically using CT or MRI to detect HT.

Results
Patients with HT represented 21.7% of all patients receiving rTPA, while symptomatic intracranial hemorrhage (sICH) represented 6.9%. Patients with HT had significantly higher blood pressure, respiratory rate, atrial fibrillation rate, NIHSS score, INR, prothrombin time, neutrophil-to-lymphocyte ratio (NLR), and lower platelet count, LDL level, higher Fazekas score, lower ASPECT score, and prolonged onset-to-needle time.

Conclusion
Predicting HT in acute ischemic stroke patients is crucial for optimizing management and potentially improving outcomes. In our study, six predictors were associated with HT: higher respiratory rate, higher atrial fibrillation rate, higher NLR, lower LDL level, higher Fazekas score, lower ASPECT score, and onset-to-needle time greater than 180 min.