bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preclinical training of future ocular surgeons: a French opinion-based study
Authors: Kitic Nicolas , Bourges Jean-Louis 
Published: February 2024

Abstract
Purpose
To assess ophthalmology residents satisfaction regarding surgical training during residency in France.

Methods
A questionnaire consisting of 28 questions was designed and sent to residents of ophthalmology across the 27 French regions.

Results
A total of 30.3% ophthalmology residents in France completed our questionnaire. All French regions participated. They rated 5,27 ± 2.42/10 the global surgical training during residency. They had performed at least one step of any type of ocular surgery for 93.4% of them, while 80.7% had completed at least one full cataract surgery, by the beginning of their second year of residency on average (Paris: 2.59 ± 1.36 semesters; regions: 4.05 ± 1.96 semesters, p < 0.0001). Only 48.9% identified a surgical mentor during their residency, but 82.2% did not clearly identify surgical goals & objectives during their training. Simulation was available for any type of ocular surgery to all residents in the Paris (Île-de-France) region and to 78.1% in other regions (p < 0.005). Residents who accessed drylabs and wetlabs gave a satisfaction score of 7.31 ± 1.89/10 and 6.39 ± 2.15/10 to it respectively. Simulation was a mandatory part of the curriculum for 35.2% of the resident. They commented on on reduced access to subspecialized surgery. They were willing for more access to simulation and surgery on real patients, as well for closer mentoring and clearly defined surgical goals within the curriculum.

Conclusion
Ophthalmology residents seemed globally satisfied with their surgical training nationwide, although we observed disparities across region. They largely acknowledged a lack of standard procedures nationwide. They acclaimed simulation during the initial phase of residency, progressively switching towards surgery on real patients. An “operating license” during residency could be a viable way for the resident to demonstrate that they have acquired enough surgical abilities to perform surgery on real patients.
Individual and systems-related factors associated with heart failure self-care: a systematic review
Authors: Kleman Carolyn , Turrise Stephanie , Winslow Heidi , Alzaghari Omar , Lutz Barbara J. 
Published: February 2024

Abstract
Background
Heart failure (HF) is a prevalent condition worldwide. HF self-care is a set of behaviors necessary for improving patient outcomes. This study aims to review and summarize the individual and system-related factors associated with HF self-care published in the last seven years (Jan 2015 – Dec 2021) using the Socioecological Model as a review framework.

Methods
An experienced nursing librarian assisted authors in literature searches of CINAHL Plus with Full Text, Ovid Nursing, PsychINFO, and PubMed databases for peer-reviewed descriptive studies. Inclusion criteria were HF sample with self-care as the outcome variable, and a quantitative descriptive design describing individual and/or system-level factors associated with self-care. Exclusion criteria were interventional or qualitative studies, reviews, published before 2015, non-English, and only one self-care behavior as the outcome variable. The search yielded 1,649 articles. Duplicates were removed, 710 articles were screened, and 90 were included in the full-text review.

Results
A subset of 52 articles met inclusion and exclusion criteria. Study quality was evaluated using modified STROBE criteria. Study findings were quantitated and displayed based on socioecological levels. Self-care confidence, HF knowledge, education level, health literacy, social support, age, depressive symptoms, and cognitive dysfunction were the most frequently cited variables associated with self-care. Most factors measured were at the individual level of the Socioecological Model. There were some factors measured at the microsystem level and none measured at the exosystem or macrosystem level.

Conclusion
Researchers need to balance the investigation of individual behaviors that are associated with HF self-care with system-level factors that may be associated with self-care to better address health disparities and inequity.
“I only seek treatment when I am ill”: experiences of hypertension and diabetes care among adults living with HIV in urban Tanzania
Authors: Ottaru Theresia A. , Wood Christine V. , Butt Zeeshan , Hawkins Claudia , Hirschhorn Lisa R. , Karoli Peter , Shayo Elizabeth H. , Metta Emmy , Chillo Pilly , Siril Hellen , Kwesigabo Gideon P. 
Published: February 2024

Abstract
Background
For adults living with HIV (ALHIV) and comorbidities, access to comprehensive healthcare services is crucial to achieving optimal health outcomes. This study aims to describe lived experiences, challenges, and coping strategies for accessing care for hypertension and/or diabetes (HTN/DM) in HIV care and treatment clinics (CTCs) and other healthcare settings.

Methodology
We conducted a qualitative study that employed a phenomenological approach between January and April 2022 using a semi-structured interview guide in six HIV CTCs in Dar es Salaam, Tanzania. We purposively recruited 33 ALHIV with HTN (n = 16), DM (n = 10), and both (n = 7). Thematic content analysis was guided by the 5As framework of access to care.

Findings
The majority of the participants were females, between the ages of 54–73, and were recruited from regional referral hospitals. HIV CTCs at regional referral hospitals had more consistent provision of HTN screening services compared to those from district hospitals and health centers. Participants sought HTN/DM care at non-CTC health facilities due to the limited availability of such services at HIV CTCs. However, healthcare delivery for these conditions was perceived as unaccommodating and poorly coordinated. The need to attend multiple clinic appointments for the management of HTN/DM in addition to HIV care was perceived as frustrating, time-consuming, and financially burdensome. High costs of care and transportation, limited understanding of comorbidities, and the perceived complexity of HTN/DM care contributed to HTN/DM treatment discontinuity. As a means of coping, participants frequently monitored their own HTN/DM symptoms at home and utilized community pharmacies and dispensaries near their residences to check blood pressure and sugar levels and obtain medications. Participants expressed a preference for non-pharmaceutical approaches to comorbidity management such as lifestyle modification (preferred by young participants) and herbal therapies (preferred by older participants) because of concerns about side effects and perceived ineffectiveness of HTN/DM medications. Participants also preferred integrated care and focused patient education on multimorbidity management at HIV CTCs.

Conclusion
Our findings highlight significant barriers to accessing HTN/DM care among ALHIV, mostly related to affordability, availability, and accessibility. Integration of NCD care into HIV CTCs, could greatly improve ALHIV health access and outcomes and align with patient preference.
The value of experts by experience in social domain supervision in the Netherlands: results from a ‘mystery guests’ project
Authors: Kleefstra Sophia M. , Frederiks Brenda J.M. , Tingen Adriënne , Reulings Petra G.J. 
Published: February 2024

Abstract
Background
User involvement and participation in the supervision of the quality of care is an important topic for many healthcare inspectorates. It offers regulators an additional view on quality, increases the legitimacy and accountability of the inspectorate, empowers users and enhancing the public’s trust in the inspectorate. To assess the accessibility of the local governmental social domain services the Joint Inspectorate Social Domain in the Netherlands worked together with people with intellectual disabilities performing as ‘mystery guests’ in an innovative project. This paper describes the findings of the evaluation of this project.

Methods
People with intellectual disabilities living at home on their own may need some help with daily activities such as administrative tasks, raising children, household tasks, managing debts or finding work. In the Netherlands they have to arrange this help at their municipality. The goal of this project was to find out how easily people with intellectual disabilities could get help from their municipality. The participants were equal partners with the JISD inspectors from the beginning: in constructing an inspection framework, in acting as mystery guest with a fictive support request, reported back the results by storytelling.

Results
The evaluation of the project showed that the JISD succeeded in their key aspect of the project: the goal to involve people with intellectual disabilities in a leading role from the beginning until the end. Their perspectives and preferences were the starting point of supervision. Pain points in accessibility became clear straight away and gave important insights for both inspectors as municipality professionals. Municipalities started to improve their services and evaluated the improvements with the clients. Furthermore, the impact on the participants themselves was also huge: they felt being taken seriously, valued and empowered.

Conclusion
Involving people with intellectual disabilities as participants in all phases of supervision processes contributes to more relevant and useful outcomes, creates mutual understanding of perspectives, as affirmed by both municipalities and inspectors, and creates empowerment of the participants. Furthermore, it fits perfectly within the United Nation Convention on the rights of persons with disabilities and the current development of ‘value driven regulation’.
Diagnosis and management of Achilles tendon ailments: the Scottish mist
Authors: Maffulli Nicola , King John B. , Migliorini Filippo , Chan Otto , Padhiar Nat , Spiezia Filippo 
Published: February 2024

AbstractThe diagnosis and management of Achilles tendon ailments continue to be widely discussed by the scientific community. Also, the nomenclature used to describe the tendinopathic lesion in patients changed over the last decades together with the evolution in the knowledge of the physiopathology of Achilles tendinopathy, and unfortunately, through ignorance and possibly laziness, confusion still abounds. To emerge from these foggy paths, some clarifications are still necessary. The present Editorial tries to clarify some of these issues.
Tricuspid mechanical valve replacement for severe tricuspid stenosis in a child who underwent surgical correction of complete atrioventricular septal defect, a rare long-term complications
Authors: Zhang Qi-Liang , Chen Yu-Kun , Lin Shi-Hao , Du Xin-Wei , Chen Qiang , Wang Shun-Min , Cao Hua 
Published: February 2024

Abstract
Background
Complete atrioventricular septal defect is a complicated congenital heart malformations, and surgical correction is the best treatment, the severe tricuspid stenosis is a rare long-term complication after the surgery.

Case presentation
We report a case with the complication of severe tricuspid stenosis 7 years after the surgical correction of complete atrioventricular septal defect in a child. Then the patient underwent tricuspid mechanical valve replacement, Glenn, atrial septostomy, and circumconstriction of the right pulmonary artery.

Conclusions
The patient recovered successfully with good short-term.
Papillary fibroelastoma originating from the atrial septum touching the mitral valve leading to infective endocarditis: a case report
Authors: Funaishi Koji , Kasahara Hirofumi , Oki Naohiko , Nakatogawa Tomoyori , Yamanoi Kazuhiro 
Published: February 2024

Abstract
Background
Cardiac papillary fibroelastoma is a rare benign tumor, which is often mistaken for a vegetation. Predominantly asymptomatic, it can cause life-threatening complications. Although rare, mobile papillary fibroelastoma movement between affected valves may hamper valve closure and damage the valve, leading to valvular regurgitation. Endothelial damage increases the risk of developing infective endocarditis. We report a rare case of a highly mobile papillary fibroelastoma originating from the atrial septum touching the mitral valve, leading to mitral regurgitation and, eventually, infective endocarditis.

Case presentation
A 26-year-old woman with suspected infective endocarditis was referred to us from a previous hospital after having experienced intermittent fever for a month. Before the fever, she had been experiencing exertional dyspnea. In addition, she had undergone a cesarean section two weeks before this admission. A transthoracic echocardiogram showed a mobile mass originating from the atrial septum touching the mitral valve with severe mitral regurgitation. Computed tomography revealed an occluded right profunda femoris artery with an embolus. Infective endocarditis associated with a mobile vegetation with high embolic risk was diagnosed, and urgent surgery was performed. Following the surgery, examinations revealed papillary fibroelastoma originating from the atrial septum and infective endocarditis of the mitral valve. The histopathological examination confirmed that a mass initially thought to be a mobile vegetation was a papillary fibroelastoma. The postoperative course was uneventful except for pericarditis. There has been no recurrence of infective endocarditis or papillary fibroelastoma.

Conclusions
The highly mobile papillary fibroelastoma was thought to have caused both chronic mitral regurgitation and infective endocarditis. Mobile papillary fibroelastomas can cause endothelial damage to nearby valves and predispose patients to infective endocarditis.
The role of Rab27 in tick extracellular vesicle biogenesis and pathogen infection
Authors: Butler L. Rainer , Singh Nisha , Marnin Liron , Valencia Luisa M. , O’Neal Anya J. , Paz Francy E. Cabrera , Shaw Dana K. , Chavez Adela S. Oliva , Pedra Joao H. F. 
Published: February 2024

Abstract
Background
The blacklegged tick, Ixodes scapularis, transmits most vector-borne diseases in the US. It vectors seven pathogens of public health relevance, including the emerging human pathogen Anaplasma phagocytophilum. Nevertheless, it remains critically understudied compared to other arthropod vectors. Ixodes scapularis releases a variety of molecules that assist in the modulation of host responses. Recently, it was found that extracellular vesicles (EVs) carry several of these molecules and may impact microbial transmission to the mammalian host. EV biogenesis has been studied in mammalian systems and is relatively well understood, but the molecular players important for the formation and secretion of EVs in arthropods of public health relevance remain elusive. RabGTPases are among the major molecular players in mammalian EV biogenesis. They influence membrane identity and vesicle budding, uncoating, and motility.

Methods
Using BLAST, an in silico pathway for EV biogenesis in ticks was re-constructed. We identified Rab27 for further study. EVs were collected from ISE6 tick cells after knocking down rab27 to examine its role in tick EV biogenesis. Ixodes scapularis nymphs were injected with small interfering RNAs to knock down rab27 and then fed on naïve and A. phagocytophilum-infected mice to explore the importance of rab27 in tick feeding and bacterial acquisition.

Results
Our BLAST analysis identified several of the proteins involved in EV biogenesis in ticks, including Rab27. We show that silencing rab27 in I. scapularis impacts tick fitness. Additionally, ticks acquire less A. phagocytophilum after rab27 silencing. Experiments in the tick ISE6 cell line show that silencing of rab27 causes a distinct range profile of tick EVs, indicating that Rab27 is needed to regulate EV biogenesis.

Conclusions
Rab27 is needed for successful tick feeding and may be important for acquiring A. phagocytophilum during a blood meal. Additionally, silencing rab27 in tick cells results in a shift of extracellular vesicle size. Overall, we have observed that Rab27 plays a key role in tick EV biogenesis and the tripartite interactions among the vector, the mammalian host, and a microbe it encounters.

Graphical Abstract
Pancreatic enzyme replacement therapy in subjects with exocrine pancreatic insufficiency and diabetes mellitus: a real-life, case–control study
Authors: Alexandre-Heymann Laure , Yaker Fetta , Lassen Pierre Bel , Dubois-Laforgue Danièle , Larger Etienne 
Published: February 2024

Abstract
Background
Exocrine pancreatic insufficiency (EPI) can be associated with all types of diabetes. Pancreatic enzyme replacement therapy (PERT) has short and long-term benefits in subjects with EPI, but its effects on diabetes control are uncertain. We aimed to study the effects of PERT initiation on glycemic control in subjects with diabetes and EPI from any cause.

Methods
In this retrospective study, we compared subjects with EPI and diabetes who were prescribed PERT with subjects with diabetes who had a fecal elastase-1 concentration dosage, but did not receive PERT. The primary outcome was the effect of PERT on hypoglycemia frequency and severity. The secondary outcomes were the effects of PERT on gastro-intestinal disorders, HbA1c and body mass index (BMI).

Results
48 subjects were included in each group. Overall, PERT did not have any significant effect on hypoglycemia frequency or severity, but hypoglycemia frequency tended to decrease in subjects with chronic pancreatitis. While 19% of subjects experienced mild hyperglycemia after PERT initiation, we did not report any keto-acidosis or any other severe adverse event. Gastro-intestinal disorders improved in 80% of subjects treated with PERT, versus in 20% of control subjects (p = 0.02). Gastro-intestinal disorders improved in 87% of subjects with recommended dosage of PERT, versus in 50% of subjects with underdosage (NS). HbA1c and BMI evolution did not differ between the groups.

Conclusions
PERT initiation is safe in subjects with diabetes and EPI. It does not globally decrease hypoglycemia severity of frequency, but is associated with a decrease in gastro-intestinal disorders.
Trial registration Retrospectively registered. The database was registered with the Commission Nationale Informatique et Libertés (CNIL), registration number: 2203351v0. The study was approved by the local ethics committee CLEP, registration number: AAA-2023-09047
Huge osteoma in the frontoparietal bone caused by trauma from 18 years ago: a case report
Authors: Tawashi Yamama , Tawashi Kenana , Ahmad Osama , Hamada Aref , Alhakeem Khaleel 
Published: February 2024

Abstract
Background
Osteomas are asymptomatic, benign tumors and are diagnosed accidentally by radiological investigations conducted for other reasons. In some cases, they may cause aesthetic or functional symptoms by affecting nearby organs. The cause of osteoma is still dialectical. Many theories suggest that inflammation, trauma, or congenital causes are behind its formation. In our case, the patient presented with a symptomatic and huge osteoma in the frontoparietal bone caused by trauma from 18 years ago.

Case presentation
A 24-year-old Syrian woman came to our hospital complaining of headaches, syncope episodes, blurred vision, and tumor formation in the frontoparietal region. The medical and surgical histories of the patient revealed appendectomy and head trauma when she was 6 years old in a traffic accident. Radiological investigations showed thickness in the space between the two bone plates in the left frontoparietal region, which reached the orbital roof without cortical destruction or periosteum reaction; the tumor size was 5 cm × 5 cm. A surgical excision was indicated. Under general anesthesia, the surgery was done for the tumor excision. The histopathology examination emphasized the diagnosis of osteoma. The follow-up for 7 months was uneventful.

Conclusion
This paper highlights the importance of focusing on the medical history of patients with osteoma in an attempt to explain the reasons for its occurrence. It stresses the need to put osteoma within the differential diagnoses of skull tumors.
Extreme drought triggers parallel shifts in wood anatomical and physiological traits in upper treeline of the Mediterranean Andes
Authors: Santini Luiz , Craven Dylan , Rodriguez Daigard Ricardo Ortega , Quintilhan Manolo Trindade , Gibson-Carpintero Stephanie , Torres Cristina Aravena , Roig Fidel A. , Muñoz Ariel A. , Venegas-Gonzalez Alejandro 
Published: February 2024

Abstract
Background
Treeline ecotones of Mediterranean ecoregions have been affected by the increasing intensity and severity of droughts. Even though the effect of droughts on forest dynamics has been widely documented, knowledge is relatively scarce of how extreme climate episodes affect the hydraulic structure and, therefore, the physiology of woody plants. The Mediterranean Andes have experienced an uninterrupted period of drought since 2010, including an extremely dry year in 2019 with approximately 80% rainfall deficit. Here, we investigated shifts in wood anatomical and physiological traits of Kageneckia angustifolia, an endemic treeline species, in response to this drought period.

Methods
We evaluated the xylem plasticity of three K. angustifolia populations across their natural distribution (31–35° SL) based on anatomical (vessel structure and distribution) and physiological (intrinsic water-use efficiency) variables in the tree rings. We focused on the period 2000–2020 that corresponds to before the megadrought (2000–2007), (ii) megadrought (2008–2018) and (iii) hyperdrought (2019–2020). The variables were annualized and analyzed by linear mixed-effects models.

Results
Our results provide insights to the anatomical and physiological mechanisms underlying the resilience of treeline forests to persistent droughts in central Chile. We found that the extreme drought in 2019–2020 triggered shifts in vessel size and frequency that increased hydraulic safety. These significant shifts in vessel traits occurred in parallel with a decrease in pit aperture area and an increase in water-use efficiency, further increasing the resilience of K. angustifolia to extreme drought stress.

Conclusions
Our results revealed coordinated shifts in vessel size and frequency and water-use efficiency in response to the megadrought, thereby reducing vulnerability to hydraulic failure. The apparent resilience of K. angustifolia to extreme droughts suggests that this adaptation to drought stress may increase its ability to tolerate novel climatic conditions of treeline environments of the Mediterranean Andes, although it is not clear whether these adaptations will be sufficient to persist in scenarios that predict intensification of climate stress. Finally, our results provide empirical evidence that integrating wood anatomical and physiological traits facilitates the understanding of resilience mechanisms that treeline forests develop in the face of increasing drought stress.