bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complex Autism Spectrum Disorder: Structural Determinants of Health and Their Impact on the Diagnosis
Authors: Canale Sarah , Weissman Britany , Noroña Carmen Rosa , Fernández-Pastrana Ivys , Adolphe Soukaina , Christiansen Audrey , Reddy Arathi , Augustyn Marilyn 
Published: October 2023

CASE:
Emmanuel is a 6.5-year-old boy who was referred to your evaluation clinic for concerns about his social skills and communication. He arrived in the United States (US) 1 year ago after an immigration trajectory that began in Haiti when he was aged 3 years; passed through Mexico, where the family was in various shelters for over a year; and concluded 2 years later, with the family eventually settling in an urban center in the northeastern United States. While in Mexico, the family was living in a camp without access to utilities. They faced significant food insecurity and experienced multiple relocations because of fears of physical safety.
Emmanuel's native language is Haitian Creole, but he learned some Spanish during the year spent in Mexico. Now in the United States, he has been enrolled for the last year in the public school system, where he participates in an inclusion English as a Second Language kindergarten classroom. The school has expressed concern about several behaviors including bolting from the classroom, shouting out inappropriately, and taking food from other children's lunches.
On initial meeting with a DBP clinician, Emmanuel's parents report that they do not have any concerns at home about his behavior, although they do feel that he “talks less than his 3 older siblings.” The 6-person household is currently living in one-room, temporary housing; they deny current food insecurity.
As part of his evaluation, you perform an Autism Diagnostic Observation Scale–2 Module 3 in English with the support of an in-person Haitian Creole interpreter. Emmanuel does not make eye contact throughout the evaluation but does respond to your questions in a combination of English and Haitian Creole. He can define the concept of a “friend” but cannot name one of his own friends. He is not able to engage in the demonstration task with words but does use gestures to indicate the actions involved in brushing teeth. His free play is perseverative and centers around fighting between the action figures.
Brief cognitive testing reveals normal nonverbal intelligence. He is unable to decode in English on achievement testing. The family completes a Social Responsiveness Scale in English, which shows normal scores except in the repetitive behaviors section, where the family endorses pacing and some restricted interests, particularly around video games.
He is not yet on an Individualized Education Plan, and there have been no formal assessments from the school except for language dominance testing indicating that his dominant language is Haitian Creole, with emerging English skills. What specific topics are unique to the evaluation for autism in an English language learner with a significant trauma history? What factors should be considered when assessing a child with a history of immigration trauma?
Assessing Parental Perceptions of Meaningful Outcomes for Children with Autism Spectrum Disorder
Authors: Close Meredith , Aberbach Gabriella , Chan Eugenia , Harstad Elizabeth 
Published: October 2023

ABSTRACT:

Background:
Outcomes of children diagnosed with autism spectrum disorder (ASD) generally focus on cognition, language, behavioral, and adaptive functioning, yet it is unknown whether this reflects patient and caregiver priorities.

Objective:
Identify parental perceptions of ASD outcomes and identify whether health care providers are currently addressing these concerns.

Methods:
Participant were 60 parents of school-aged children previously diagnosed with ASD participating in a larger autism outcomes study. Parents answered open-ended question, “What aspect of your child's functioning matters most for your child at this time?” They also ranked a list of outcome categories (thinking and reasoning skills, daily living skills, etc). Parents answered a second open-ended question “What should healthcare providers be asking about how your child is doing, that they may not be currently asking?” Open-ended independent coding and thematic analysis were used to identify themes for the open-ended questions.

Results:
The most common themes identified with “what aspect of your child's functioning matters most” were “Social,” “Communication,” “Emotional,” and “Behavior.” These were similar to the results of a ranking question in which parents ranked “Communicating with and understanding others,” “Social skills,” and “Behavior” as most important. “Emotional” was a unique theme, although there is potential overlap between this and the theme of “Behavior.” The most common theme identified with the question about what health care providers should be asking was “Social,” followed by “Nothing.”

Conclusion:
This study demonstrates that parental concerns largely match previous outcome categories, with the exception of a theme identified as “Emotional” which may overlap with “Behavior.”
AMNIOTIC MEMBRANE GRAFTING FOR A CASE OF BILATERAL GIANT FULL-THICKNESS MACULAR HOLE IN ALPORT SYNDROME AFTER CATARACT SURGERY
Authors: Roubelat François-Philippe , Gualino Vincent , Fournié Pierre R. , Soler Vincent J. 
Published: October 2023

Purpose:
The purpose of this study was to describe the surgical management of bilateral giant full-thickness macular hole with sudden onset two months after cataract surgery in a patient with Alport syndrome.

Methods:
This was an observational, single-case report.

Results:
A 54-year-old woman with a history of Alport syndrome presented with severe bilateral visual loss two months after cataract surgery. The diagnosis of bilateral giant full-thickness macular hole was made. We found the absence of the internal limiting membrane and the inability to lift and peel a continuous posterior hyaloid sheet during surgical management with 25-gauge pars plana vitrectomy (left eye). Amniotic membrane grafting followed by gas tamponade were performed for hole closure. The hole remained closed but vision was poorly restored two months after.

Conclusion:
Cataract surgery in patients with Alport syndrome could promote early development of giant full-thickness macular hole. Collagen defects could underlie internal limiting membrane absence and the inability to properly peel the posterior hyaloid.
A NOVEL FINDING IN THE DIAGNOSIS OF PRIMARY VITREORETINAL LYMPHOMA: A CASE REPORT
Authors: Maleki Arash 
Published: October 2023

Purpose:
Introduce a unique case of primary vitreoretinal lymphoma with a new optical coherence tomography finding.

Methods:
A case report. A 67-year-old healthy man with complaints of blurry vision in his right eye.

Results:
The patient's visual acuity was 20/60 and 20/20 in the right and left eyes, respectively. Anterior segment examination of the right eye demonstrated mild inflammation. Dilated fundoscopy revealed 2+ vitreous haze and 4+ disk edema. Optical coherence tomography of the macula in the right eye revealed optic nerve head swelling and thickening of the retina. Fluorescein angiography demonstrated mild leakage and staining of vessels along the inferotemporal arcade in the right eye. Labs were within normal limits except positive Herpes simplex virus 1 IgG. Initially, the patient was treated for herpetic panuveitis for 3 weeks with a favorable response. However, the clinical condition deteriorated as a new abnormality was identified in the macular region of the right eye through optical coherence tomography. Considering intraocular lymphoma as a potential diagnosis, the patient underwent a diagnostic vitrectomy. The vitreous sample analysis confirmed primary vitreoretinal lymphoma through immunohistochemistry and flow cytometry. The patient exhibited a rapid response after the initiation of intravenous and intravitreal methotrexate treatment.

Conclusion:
The presence of subretinal fluid accompanied by suspended hyperreflective lesions originating from the roof of the subretinal fluid pocket on the optical coherence tomography of macula “stalactite sign” may serve as a characteristic sign indicative of primary vitreoretinal lymphoma; however, further investigation using robust studies is necessary to examine this hypothesis.
VITREORETINAL ABNORMALITIES DURING MACULAR HOLE REPAIR IN ALPORT SYNDROME
Authors: Zhou Brenda , Heisel Curtis J. , Zhu Ivy , Gill Manjot K. 
Published: October 2023

Purpose:
The purpose of the study was to describe abnormal vitreoretinal findings during macular hole repair in Alport syndrome.

Methods:
A case report of preoperative, intraoperative, and postoperative findings related to macular hole surgery in a patient with Alport syndrome was discussed.

Results:
A 50-year-old woman with Alport syndrome was found to have bilateral full-thickness macular holes. Surgery was recommended for her left eye given recent onset of vision loss and smaller hole size (313 μm). Intraoperatively, the vitreous was found to have fine fibrillar strands and to be abnormally adherent to the retinal surface. There was little to no internal limiting membrane present. Vitrectomy was performed with posterior cortical hyaloid peeling and 15% C3F8 gas tamponade. Two months after surgery, the macular hole was successfully closed.

Conclusion:
Abnormal vitreous composition and adherence to the retinal surface may contribute to macular hole formation in patients with Alport syndrome. Standard surgical approaches including internal limiting membrane peeling may not be feasible, although thorough removal of the posterior cortical hyaloid may be sufficient to achieve macular hole closure.
Current opinion: advances in machine perfusion and preservation of vascularized composite allografts – will time still matter?
Authors: Muss Tessa E. , Loftin Amanda H. , Oh Byoung Chol , Brandacher Gerald 
Published: October 2023

Purpose of review
A major hurdle hindering more widespread application of reconstructive transplantation is the very limited cold ischemia time (CIT) of vascularized composite allografts (VCAs). In this review, we discuss cutting edge machine perfusion protocols and preservation strategies to overcome this limitation.

Recent findings
Several preclinical machine perfusion studies have demonstrated the multifactorial utility of this technology to extend preservation windows, assess graft viability prior to transplantation and salvage damaged tissue, yet there are currently no clinically approved machine perfusion protocols for reconstructive transplantation. Thus, machine perfusion remains an open challenge in VCA due to the complexity of the various tissue types. In addition, multiple other promising avenues to prolong preservation of composite allografts have emerged. These include cryopreservation, high subzero preservation, vitrification and nanowarming. Despite several studies demonstrating extended preservation windows, there are several limitations that must be overcome prior to clinical translation. As both machine perfusion and subzero preservation protocols have rapidly advanced in the past few years, special consideration should be given to their potential complementary utilization.

Summary
Current and emerging machine perfusion and preservation technologies in VCA have great promise to transform the field of reconstructive transplantation, as every extra hour of CIT helps ease the complexities of the peri-transplant workflow. Amongst the many advantages, longer preservation windows may allow for elective procedures, improved matching, establishment of novel immunomodulatory protocols and global transport of grafts, ultimately enabling us the ability to offer this life changing procedure to more patients.
Penile fracture: a case series of 18 patients
Authors: Molla Yohannis D. , Erku Belay A. , Kassa Samrawit A. , Alemu Hirut T. , Mekonnen Desyibelew C. 
Published: October 2023

Introduction:
Penile fractures are a rare urological emergency. It is defined as ‘rupture of the tunica albuginea of one or both corpora cavernosa. The corpus spongiosum and the urethra may also be involved in this process.’ The tunica albuginea is stiff and significantly thinner during erection than in the flaccid state, which is when injury generally happens.

Method:
This case series was completed between January 2018 and January 2023 at the Department of General Surgery. Eighteen patients suspected of having penile fractures participated in were included this study. All patients were thoroughly evaluated upon hospital admission to identify the diagnosis, length of time since the accident, the site of the fracture, the extent of the penile hematoma, occurrence of blood at the external meatus, presence of urine retention, and intraoperative outcomes.

Results:
The patients were between the ages of 24 and 70, with a mean age of 37. The duration before the presentation ranged from 7 h to 1 month (the median was 22 h). Sexual intercourse was the cause in 12 (66%) cases, rolling in the bed in three cases (16%), and blunt trauma in three cases (kicking and the edge of the bed) (16%). Pain and swelling were present in all of the patients. In 15 patients (or 83%), there was evidence of penile deviation. At presentation, 15 (72%) patients reported experiencing rapid detumescence, discomfort, and penile swelling after hearing a cracking (popping) sound. None of these individuals experienced urine retention or urethral hemorrhage, and all were emptied on their own following the episode. Physical examination showed penile ecchymosis, swelling, and substantial discomfort when the penile shaft was examined. All but three patients had an evident penile deformity. Surgery was performed under spinal anesthesia in 14 (77.7%) patients. Four patients with a delayed presentation (more than 1 week) were managed conservatively.

Conclusion:
As a true urologic emergency, penile fractures should be treated immediately to reduce pain and swelling and ensure better functional and esthetic outcomes. Despite taking more time, a subcoronal circumcising degloving incision is the ideal method because it is exploratory and esthetically pleasing.
Dramatic Shift in the Etiology of Genital Ulcer Disease Among Patients Visiting a Sexually Transmitted Infections Clinic in Lilongwe, Malawi
Authors: Chen Jane S. , Matoga Mitch M. , Gaither Claudia F. , Jere Edward , Mathiya Esther , Bonongwe Naomi , Krysiak Robert , Banda Gabriel , Hoffman Irving F. , Miller William C. , Juliano Jonathan J. , Rutstein Sarah E. 
Published: October 2023

BackgroundGenital ulcer diseases (GUDs) are a common syndrome associated with sexually transmitted infections. Genital ulcer diseases increase the risk of HIV transmission, necessitating appropriate diagnosis and treatment. We provide an updated GUD etiology assessment in Malawi to guide diagnostic development and treatment algorithms.MethodsWe enrolled patients 18 years or older presenting with GUD at a sexually transmitted infection clinic in Lilongwe, Malawi, between May and October 2021. We purposively sampled by HIV status. Swabs of ulcers were tested forTreponema pallidum, herpes simplex virus (HSV)-1 and HSV-2,Haemophilus ducreyi, andChlamydia trachomatisusing polymerase chain reaction. Blood was collected for syphilis and HSV-2 serologies and acute HIV testing. Participants were treated per Malawi guidelines. Ulcer resolution (size reduced by >50%) was evaluated 14 days later.ResultsFifty participants enrolled (30 without HIV, 2 with acute HIV infection, 18 with HIV seropositivity; 32 men, 18 women). Forty-six (92%) had an etiology identified. Syphilis was more common among those without HIV (22 of 30 [73%]) than participants with HIV (PWH; 8 of 20 [40%];P= 0.04). Herpes simplex virus was more common among PWH (11 of 20 [55%]) than participants without (2 of 30 [7%];P= 0.0002). One-fifth (9 of 50 [18%]) hadH. ducreyi. Among those who returned for follow-up (n = 45), 9 (20%) had unresolved ulcers; persistent GUD was slightly more common in PWH (6 of 19 [32%]) than participants without (3 of 26 [12%];P= 0.14).ConclusionsWe observed a dramatic increase in syphilis ulcer proportion in a population whose GUDs were previously HSV predominant. Observed differences in etiology and resolution by HIV status could play an important role in the ongoing transmission and treatment evaluation of GUD.
Prospective Laboratory Evaluation of the cobas Plasma Separation Card for HIV and Treponema pallidum Antibody Analysis
Authors: Vanroye Fien , Van den Bossche Dorien , Vercauteren Koen 
Published: October 2023

Background
The cobas Plasma Separation Card (PSC; Roche Diagnostics) was developed for HIV viral load testing. This study evaluates the performance of HIV and Treponema pallidum (Tp) antibody (Ab) detection on PSCs as an alternative to dried blood spots (DBSs).

Methods
EDTA whole blood samples were collected from HIV-positive (n = 100), HIV-negative (n = 50), Tp-positive (n = 100), and Tp-negative patients (n = 50) and spotted on DBS and PSC. Antibody detection performance was evaluated for HIV Ab using the Genscreen ULTRA HIV Ag-Ab test (Bio-Rad) and for Tp Ab using the Syphilis Total Ab test (Bio-Rad). Plasma was used as a reference specimen.

Results
Receiver operating characteristic curve analysis for DBS and PSC generated areas under the curve (AUC + 95% confidence interval) of 0.985 (0.960–1.000) and 0.987 (0.973–1.000) for HIV Ab and 1.000 (1.000–1.000) and 0.996 (0.983–1.000) for Tp Ab, respectively. Receiver operating characteristic areas under the curve were not significantly different between DBS and PSC for HIV or TP Ab. At selected cutoff values rendering at least 99% sensitivity for HIV Ab detection, the specificity was 96% on DBS and 68% on PSC. For Tp Ab detection at 90% sensitivity, 100% specificity is reached on both DBS and PSC (exceeding the required 95%). However, the median quantitative HIV and Tp Ab signal of positive samples significantly decreased in PSC compared with DBS and plasma.

Conclusions
Although receiver operating characteristic analysis does not seem to indicate significant differences in performance between DBS and PSC, the significant reduction in quantitative Ab detection signal dictates card composition optimization before its use for HIV and Tp Ab detection can be advised.
Brazilian Clinical Practice Guidelines for Sexually Transmitted Infections That Cause Urethral Discharge: Assessment According to the AGREE II and Critical Analysis Based on the WHO Recommendations
Authors: Gaspar Pâmela Cristina , Barreto Jorge Otávio Maia , Bigolin Alisson , Miranda Angélica E. , Aires Júnior Luiz F. , Bazzo Maria Luiza , Díaz Bermúdez Ximena Pamela , Benzaken Adele Schwartz 
Published: October 2023

Background
Sexually transmitted infections (STI) can have severe consequences. In Brazil, case management is recommended by the Clinical Protocol and Therapeutical Guidelines for Comprehensive Care for People with STIs (PCDT-IST). This study assessed the quality of PCDT-IST (2021) and reviewed the main recommendations for the management of STI that cause urethral discharge compared with the World Health Organization (WHO) STI Guidelines.

Methods
The PCDT-IST (2021) quality was independently assessed by 4 appraisers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II). The PCDT-IST (2021) and the WHO Guidelines for the Management of Symptomatic STI (2021) were compared considering 14 different assessment domains.

Results
The PCDT-IST (2021) scores in the AGREE II domains were: Rigor of Development (58%), Applicability (35%), Editorial Independence (38%), Scope and Purpose (78%), Stakeholder Involvement (74%), and Clarity and Presentation (82%). The overall score was 67%, and all appraisers recommended the Brazilian guideline. Regarding the PCDT-IST (2021) and the WHO STI Guidelines (2021) comparation, 10 domains would be relevant for further reviewing the Brazilian recommendations: Diagnostic tests; Etiological approach; Treatment for recurrent urethral discharge; Treatment for urethritis without etiological agent identification; Treatment for gonococcal urethritis; Treatment for chlamydial urethritis; Retreatment for gonococcal infections; Treatment for Mycoplasma genitalium urethritis; Treatment for Trichomonas vaginalis urethritis; 10. Flowcharts.

Conclusions
The PCDT-IST (2021) has a reasonable degree of quality. However, the domains of Applicability, Rigor of Development, and Editorial Independence must be better ensured. The guidelines comparison will help to select key topics that should be addressed with priority in the following national STI guidelines updates.
Sexually Transmitted Infections and the Risk of Reinfection Within 12 Months: A Population-Based Cohort
Authors: Kumbaroff Zoe , Duff Putu , Saxton Peter , Sonder Gerard J.B. , Thirkell Callum , Scott Julia , Walls Tony , Anglemyer Andrew 
Published: October 2023

Background
Chlamydia, gonorrhea, and syphilis are common sexually transmitted infections that disproportionately affect specific groups in New Zealand (NZ). Predictors of reinfection are not well studied in NZ but could inform public health strategies to decrease sexually transmitted infection (STI) incidence.

Methods
New Zealand–wide chlamydia, gonorrhea, and syphilis cases during 2019 were identified using nationally collected data. Cases were followed-up to identify reinfection with the same STI within 12 months of initial infections. Logistic regression models were used to identify predictors for each STI reinfection.

Results
Determinants identified for increased odds of chlamydia reinfection were age groups 16–19 and 20–24 years, females, Māori and Pacific peoples, cases in the Northern region, and cases with at least one test before the initial infection. Age 40 years and older was associated with lower odds of gonorrhea reinfection, as was being of Asian ethnicity, living in Midland or Southern regions, and reporting heterosexual behavior. Region was the only statistically significant predictor for syphilis reinfection, with higher odds of reinfection for people living in the Central region.

Conclusions
Our findings reflect disproportionate STI rates for some groups in NZ, with younger age groups, Māori and Pacific peoples, men who have sex with men, and people living in the Northern region experiencing higher odds of reinfection. Groups identified with higher odds for reinfection require increased access to culturally responsive health services to treat, understand, and prevent possible reinfection. Changes to current public health strategies could include culturally specific behavioral counseling, and improvements to and adherence to effective contract tracing.