bluuebunny/crossref_metadata_2025_split huggingface dataset:
First-in-human feasibility study of the aXess graft (aXess-FIH): 6-Month results
Authors: Tozzi Matteo , De Letter Jan , Krievins Dainis , Jushinskis Janis , D’Haeninck Annick , Rucinskas Kestutis , Miglinas Marius , Baltrunas Tomas , Nauwelaers Sigi , De Vriese An S , Moll Frans , Vermassen Frank 
Published: February 2024

Objective: The creation of an arteriovenous fistula (AVF) is considered the most effective hemodialysis (HD) vascular access. For patients who are not suitable for AVF, arteriovenous grafts (AVGs) are the best access option for chronic HD. However, conventional AVGs are prone to intimal hyperplasia, stenosis, thrombosis, and infection. Xeltis has developed an AVG as a potential alternative to currently available AVGs based on the concept of endogenous tissue restoration. The results of the first 6-month follow-up are presented here. Methods: The aXess first-in-human (FIH) study [NCT04898153] is a prospective, single-arm, multicenter feasibility study that evaluates the early safety and performance of the aXess Hemodialysis Graft. A total of 20 patients with end-stage renal disease were enrolled across six European investigational sites. Results: At 6-months follow-up, all grafts were patent with primary and secondary patency rates were 80% and 100%, respectively. Three patients required a re-intervention to maintain graft patency, while one re-intervention was required to restore patency. One graft thrombosis and zero infections were reported. Conclusion: The expected advantages of the novel aXess Hemodialysis Graft over conventional AVGs would be evaluated by the analysis on long-term safety and effectiveness during the 5-year follow-up of the currently ongoing trial.
Safety and efficacy of a new covered stent in hemodialysis vascular access outflow stenosis: A Brazilian multicenter retrospective study
Authors: Harduin Leonardo de Oliveira , Barroso Thiago Almeida , Guerra Julia Bandeira , Filippo Márcio Gomes , de Almeida Leonardo Cortizo , Vieira Brunno Ribeiro , Mello Renata Silveira , Galhardo Adriano Martins , Castro-Santos Guilherme de , Virgini-Magalhães Carlos Eduardo , Strogoff-de-Matos Jorge Paulo 
Published: February 2024

Background: Vascular stenosis commonly leads to dysfunction in hemodialysis vascular access. Although percutaneous transluminal angioplasty is an established treatment, stent utilization has increased in the last decade as an alternative solution to extend the access function. This study evaluated the safety and initial results of a new impermeable covered stent for treating vascular access outflow stenosis. Methods: Investigators retrospectively analyzed 114 hemodialysis patients treated with polytetrafluorethylene-covered stents from September 2018 to September 2022 across four centers. Lesions treated were de novo or restenotic and located in the venous graft anastomosis, outflow segment, cephalic arch, and basilic swing point. Patients were followed by in-person physical examination at 1, 3, and 6 months, and Duplex ultrasound was performed to evaluate the vascular access circuit and in-stent restenosis. The primary efficacy endpoint was target lesion primary patency at 1, 3, and 6 months. Secondary endpoints included access circuit primary patency and secondary patency at 1, 3, and 6 months. The primary safety endpoint was freedom from local or systemic serious adverse events through 30 days post-procedure. Results: Forty-four patients had thrombosed access at the initial presentation, and 41 patients presented with recurrent stenosis. The target lesion primary patency rates at 1, 3, and 6 months were 100%, 89.4%, and 74%, respectively. The access circuit primary patency rates were 100% at 1 month, 85% at 3 months, and 62.7% at 6 months. The secondary patency rates at 1, 3, and 6 months were 100%, 96.4%, and 94.6%, respectively. In the adjusted multivariate Cox regression analysis, only recurrent lesions and female gender were associated with reduced primary patency rates. No serious adverse event was observed through the first 30 days post-procedure. Conclusion: In this retrospective analysis, a new covered stent was shown to be safe and effective for treating peripheral outflow stenosis in vascular access.
Vascular access challenges in hemodialysis patients with superior vena cava syndrome
Authors: D’Amico Rosalinda , Nicoli Andrew , Zdoroveac Andrei , Gürke Lorenz , Isaak Andrej 
Published: February 2024

Background: Superior vena cava syndrome in hemodialysis patients resulting from previous or current use of a tunneled central vein catheter is a rare but potentially severe condition. Two aspects have to be addressed during management and treatment: the restoration of central venous flow and the creation of an alternative vascular access to guarantee hemodialysis. Research design: Conforming to the current guidelines and literature, we present a stepwise approach and discuss therapeutic options. The removal of the tunneled central vein catheter should be attempted and a native vascular access created whenever feasible. Results: First, an upper extremity AVF should be preserved or, as in our case, made functional. Endovascular treatment of CVSO should primarily consist of balloon dilatation. Placement of a stent or stent graft should be considered as a secondary option. HeRO graft placement may be considered in recurrent CVSO and recanalization with a Surfacer. LL-AVF or AVG need to be discussed and may be an alternative for certain HD patients when the risk of lower limb ischemia and infection is considered. Conclusion: Several therapeutic options are available and the basic principles are well established in the literature, although the level of evidence is not high. Therefore, we propose a stepwise and interdisciplinary approach to guide the challenging decision-making process in SVC.
Longitudinal enlargement of choroid plexus is associated with chronic lesion expansion and neurodegeneration in RRMS patients
Authors: Klistorner Samuel , Barnett Michael H , Wang Chenyu , Parratt John , Yiannikas Con , Klistorner Alexander 
Published: February 2024

Background and Objective: We explored dynamic changes in the choroid plexus (CP) in patients with relapsing-remitting multiple sclerosis (RRMS) and assessed its relationship with chronic lesion expansion and atrophy in various brain compartments. Methods: Fifty-seven RRMS patients were annually assessed for a minimum of 48 months with 3D FLAIR, pre- and post-contrast 3D T1 and diffusion-weighted magnetic resonance imaging (MRI). The CP was manually segmented at baseline and last follow-up. Results: The volume of CP significantly increased by 1.4% annually. However, the extent of CP enlargement varied considerably among individuals (ranging from −3.6 to 150.8 mm3 or −0.2% to 6.3%). The magnitude of CP enlargement significantly correlated with central ( r = 0.70, p < 0.001) and total brain atrophy ( r = −0.57, p < 0.001), white ( r = −0.61, p < 0.001) and deep grey matter atrophy ( r = −0.60, p < 0.001). Progressive CP enlargement was significantly associated with the volume and extent of chronic lesion expansion ( r = 0.60, p < 0.001), but not with the number or volume of new lesions. Conclusion: This study provides evidence of progressive CP enlargement in patients with RRMS. Our findings also demonstrate that enlargement of the CP volume is linked to the expansion of chronic lesions and neurodegeneration of periventricular white and grey matter in RRMS patients.
The Northern New England Rapid Deployment Valve Experience: Survival and Procedural Outcomes From 2015 to 2021
Authors: Fallon John M. , Malenka David J. , Ross Cathy S. , Ramkumar Niveditta , Seshasayee Shravanthi M. , Westbrook Benjamin M. , Hirashima Fuyuki , Quinn Reed D. 
Published: February 2024

Objective: The optimal approach and choice of initial aortic valve replacement (AVR) is evolving in the growing era of transcatheter AVR. Further survival and hemodynamic data are needed to compare the emerging role of rapid deployment (rdAVR) versus stented (sAVR) valve options for AVR. Methods: The Northern New England Cardiovascular Database was queried for patients undergoing either isolated AVR or AVR + coronary artery bypass grafting (CABG) with rdAVR or sAVR aortic valves between 2015 and 2021. Exclusion criteria included endocarditis, mechanical valves, dissection, emergency case status, and prior sternotomy. This resulted in a cohort including 1,616 sAVR and 538 rdAVR cases. After propensity weighting, procedural characteristics, hemodynamic variables, and survival outcomes were examined. Results: The breakdown of the overall cohort (2,154) included 1,164 isolated AVR (222 rdAVR, 942 sAVR) and 990 AVR + CABG (316 rdAVR, 674 sAVR). After inverse propensity weighting, cohorts were well matched, notable only for more patients <50 years in the sAVR group (4.0% vs 1.9%, standardized mean difference [SMD] = −0.12). Cross-clamp (89 vs 64 min, SMD = −0.71) and cardiopulmonary bypass (121 vs 91 min, SMD = −0.68) times were considerably longer for sAVR versus rdAVR. Immediate postreplacement aortic gradient decreased with larger valve size but did not differ significantly between comparable sAVR and rdAVR valve sizes or overall (6.5 vs 6.7 mm Hg, SMD = 0.09). Implanted rdAVR tended to be larger with 51% either size L or XL versus 37.4% of sAVR ≥25 mm. Despite a temporal decrease in pacemaker rate within the rdAVR cohort, the overall pacemaker frequency was less in sAVR versus rdAVR (4.4% vs 7.4%, SMD = 0.12), and significantly higher rates were seen in size L (10.3% vs 3.7%, P < 0.002) and XL (15% vs 5.6%, P < 0.004) rdAVR versus sAVR. No significant difference in major adverse cardiac events (4.6% vs 4.6%, SMD = 0.01), 30-day survival (1.5% vs 2.6%, SMD = 0.08), or long-term survival out to 4 years were seen between sAVR and rdAVR. Conclusions: Rapid deployment valves offer a safe alternative to sAVR with significantly decreased cross-clamp and cardiopulmonary bypass times. Despite larger implantation sizes, we did not appreciate a comparative difference in immediate postoperative gradients, and although pacemaker rates are improving, they remain higher in rdAVR compared with sAVR. Longer-term hemodynamic and survival follow-up are needed.
Heat-related illness in Singapore: Descriptive analysis of a tertiary care center from 2008 to 2020
Authors: Okada Yohei , Aik Joel , Ho Andrew Fu Wah , Ning Yilin , Ong Marcus Eng Hock 
Published: February 2024

Background This study aimed to describe the clinical characteristics and epidemiology of heat-related illnesses presented at a tertiary hospital in Singapore. Method This retrospective observational study utilized electronic health records from the emergency department (ED) of Singapore General Hospital. Patients primarily diagnosed with heat-related illnesses from 2008 to 2020, were analyzed. The annual number of cases and the temporal trend of heat-related illnesses were described, along with the characteristics of patients. Results Among the 1,833,908 patients registered at the ED, 426 patients had diagnoses of heat-related illnesses. The median age (interquartile range [IQR]) was 32 (22, 43) years, with 303 (71%) being male and 201 (47%) not being Singapore citizens. The annual number of cases ranged from a minimum of 21 in 2019 to a maximum of 49 cases in 2015, except for four cases in 2020. Heat-related illnesses occurred most commonly on Sundays (233, 55%) and in December (97, 23%). A significant number of cases in December coincided with the day of an annually organized marathon (91, 21%). Approximately half of the total cases required hospitalization, with 183 (43%) admitted to the general ward and 31 (7%) admitted to the intensive care unit. The 30-day mortality was 2 (0.5%). Conclusion This descriptive study indicated the unique characteristics of heat-related illness in a tertiary care hospital in Singapore. These local contexts may be valuable to consider preventative measures for heat-related illness, in preparation for future extreme weather events related to climate change.
Effectiveness of digital games promoting young people's mental health: A review of reviews
Authors: Vié Clara , Govindin-Ramassamy Kyllian , Thellier Dimitri , Labrosse David , Montagni Ilaria 
Published: February 2024

Objectives Digital games are a popular form of entertainment for youth. They are often used as a therapy for psychological problems, a mental health promotion intervention, and a preventative measure. Systematic reviews and meta-analyses have been conducted to assess the effectiveness of mental health-related digital games. However, a synthesis considering all evaluation results to inform their development is missing. Methods We performed a review of reviews to synthetize results of previous research to describe the impact of digital games on the mental health of young people aged <30 years old. We considered systematic reviews and meta-analyses published between 2012 and 2022. Searches were conducted in Scopus, Google Scholar, Pubmed, and Cochrane library systematic reviews (CENTRAL) during October 2023. Results Our final selection included 10 systematic reviews and meta-analyses on interventions targeting youth of both sexes aged 2–29 years old across the world. In total, 218 interventions were identified. Selected articles reported different types of games, e.g., active and non-active video games, virtual reality games, serious games. Not all digital games were conscientiously evaluated, but, in general, their impact on mental health was positive. Regarding the quality, 5 studies were of high quality, 3 of moderate quality and 2 of low quality. Conclusions Overall, elements of gamification were well-accepted, but they lacked assessment through rigorous experimental conditions. Digital games for mental health are promising, but in order to be consistently effective in promoting young people's mental health and prevent psychological diseases, they should present specific features.
Digital learning about patients: An online survey of German medical students investigating learning strategies for family medical video consultations
Authors: Särchen Franziska , Springborn Susanne , Mortsiefer Achim , Ehlers Jan 
Published: February 2024

Objective Training in video consultations is seldom included in the curriculum for future physicians. Exploration of preferred teaching methods and learning objectives in this context among medical students remains limited. This study addresses this research gap by conducting a survey among medical students in Germany to assess their educational requirements concerning video consultations and patient-centred distance learning. Methods This quantitative study employed an online questionnaire designed for German medical students, following the guidelines of the International Association for Health Professions Education. The study primarily focused on discerning the didactic preferences related to patient-centred digital teaching regarding family medical video consultations. We provided a detailed explanation of a concrete learning concept, a family medical synchronous distance learning seminar. Subsequently, we surveyed students to gauge their needs, expectations, and evaluations of this concept. The collected data were subjected to descriptive analysis. Results The analysis revealed that students aspire to offer video consulting services to their patients in the future (sample size (n) = 369, median (med) = 68 of 101 Likert scale points, interquartile range (IQR) = 53.75), despite having limited knowledge in this area (n = 353, med = 21, IQR = 33.25). To acquire expertise in telehealth, students favor blended learning models (n = 331, med = 76, IQR = 50). They also recognize the benefits of distance learning, particularly for students with family responsibilities or those who must travel long distances to their learning institutions,. The presented distance seminar concept resonated with them (n = 278, med = 72.5, IQR = 50.5), surpassing five other digital learning models in preference. Furthermore, they expressed a desire for its continued implementation beyond the Coronavirus SARS-CoV-2 pandemic (n = 188, med = 77.5, IQR = 44.75). Conclusions The deficiency in medical school education regarding video consultations requires attention. This issue could be resolved by integrating one of the five distance learning concepts outlined in this article.
Evidence of Stroke in Glaucoma Patients
Authors: Malvankar-Mehta Monali S. , Rahman Mushfiqur , Suri Ashvinder , Hutnik Cindy M. L. 
Published: February 2024

Background As the communal cause of irreversible vision loss in seniors, glaucoma affects more than 67 million people worldwide. Those who suffer from glaucoma have traditionally demonstrated a higher rate of developing stroke. Numerous studies have investigated the relationship between glaucoma and increased stroke risks, but they differ wildly in conclusive findings. To better elucidate the overall findings of the collective studies, a systematic review with the objective of determining the relationship between glaucoma and an increased risk of stroke. Methods A systematic database search including MEDLINE, EMBASE, and Cochrane Library as well as unpublished literature was done. Distiller SR, a systematic review software was utilized. After two levels of screening, “Title and Abstract” and “Full text” screening, risk of bias assessment and extraction of the data from the included articles were conducted. STATA 14.0 was used to conduct the meta-analysis. The hazard ratio (HR) was the primary outcome measure. Results Nine studies (376,650 subjects) were included in the analysis. Results indicated a significant hazard of stroke in patients with open-angle glaucoma (HR = 1.36, 95% confidence interval [CI]: [1.08, 1.71]), normal-tension glaucoma (HR = 6.34, 95% CI: [4.8, 8.38]), and neovascular glaucoma (HR = 2.07; CI: [1.41, 3.03]). Studies examining risks of stroke development showed a significant increase in the relative risks (RR) of developing stroke for those with glaucoma (RR = 2.10, CI: [1.64, 2.68]). Conclusions The hazard of developing stroke could be greater for patients with glaucoma. However, randomized controlled trials with longer-term follow-ups need to be conducted in the future in order to make strong conclusions.
Comparative phylogenetic analysis of the mediator complex subunit in asparagus bean (Vigna unguiculata ssp. sesquipedialis) and its expression profile under cold stress
Authors: Liang Le , Wang Dong , Xu Dongmei , Xiao Jiachang , Tang Wen , Song Xueping , Yu Guofeng , Liang Zongxu , Xie Minghui , Xu Zeping , Sun Bo , Tang Yi , Huang Zhi , Lai Yunsong , Li Huanxiu 
Published: February 2024

Abstract
Background
The mediator complex subunits (MED) constitutes a multiprotein complex, with each subunit intricately involved in crucial aspects of plant growth, development, and responses to stress. Nevertheless, scant reports pertain to the VunMED gene within the context of asparagus bean (Vigna unguiculata ssp. sesquipedialis). Establishing the identification and exploring the responsiveness of VunMED to cold stress forms a robust foundation for the cultivation of cold-tolerant asparagus bean cultivars.

Results
Within this study, a comprehensive genome-wide identification of VunMED genes was executed in the asparagus bean cultivar 'Ningjiang3', resulting in the discovery of 36 distinct VunMED genes. A phylogenetic analysis encompassing 232 MED genes from diverse species, including Arabidopsis, tomatoes, soybeans, mung beans, cowpeas, and asparagus beans, underscored the highly conserved nature of MED gene sequences. Throughout evolutionary processes, each VunMED gene underwent purification and neutral selection, with the exception of VunMED19a. Notably, VunMED9/10b/12/13/17/23 exhibited structural variations discernible across four cowpea species. Divergent patterns of temporal and spatial expression were evident among VunMED genes, with a prominent role attributed to most genes during early fruit development. Additionally, an analysis of promoter cis-acting elements was performed, followed by qRT-PCR assessments on roots, stems, and leaves to gauge relative expression after exposure to cold stress and subsequent recovery. Both treatments induced transcriptional alterations in VunMED genes, with particularly pronounced effects observed in root-based genes following cold stress. Elucidating the interrelationships between subunits involved a preliminary understanding facilitated by correlation and principal component analyses.

Conclusions
This study elucidates the pivotal contribution of VunMED genes to the growth, development, and response to cold stress in asparagus beans. Furthermore, it offers a valuable point of reference regarding the individual roles of MED subunits.
The biochemical and growth-associated traits of basil (Ocimum basilicum L.) affected by silver nanoparticles and silver
Authors: Shahraki Shahla Hashemi , Ahmadi Tayebeh , Jamali Babak , Rahimi Mehdi 
Published: February 2024

Abstract
Background
The biochemical and growth changes resulting from exposure of basil (Ocimum basilicum L.) seedlings to silver nanoparticles and silver were investigated. Over a two-week period, seedlings were exposed to different concentrations (0, 40, and 80 ppm) of silver nanoparticles and silver.

Results
Our findings revealed that at concentrations of 40 and 80 ppm, both silver nanoparticles and silver nitrate led to decreased weight, root and shoot length, as well as chlorophyll a and b content. Conversely, these treatments triggered an increase in key biochemical properties, such as total phenols, carotenoids and anthocyanins, with silver nanoparticles showing a more pronounced effect compared to silver nitrate. Moreover, the levels of malondialdehyde (MDA) and hydrogen peroxide (H2O2) rose proportionally with treatment concentration, with the nanoparticle treatment exhibiting a more substantial increase. Silver content showed a significant upswing in both roots and leaves as treatment concentrations increased.

Conclusions
Application of varying concentrations of silver nanoparticles and silver nitrate on basil plants resulted in reduced growth and lower chlorophyll content, while simultaneously boosting the production of antioxidant compounds. Notably, anthocyanin, carotenoid, and total phenol increased significantly. However, despite this increase in antioxidant activity, the plant remained unable to fully mitigate the oxidative stress induced by silver and silver nanoparticles.