bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le genre de l’immigration et de la naturalisation
Authors: Guerry Linda 
Published: November 2023

Alors que les femmes ont toujours constitué une part importante des flux d’immigration en France, la dimension sexuée du phénomène a été très peu étudiée par les historiens. L’entre-deux-guerres, période exceptionnelle d’immigration, méritait qu’on s’y intéresse. Comment représente-t-on les hommes et les femmes immigrants ? L’immigration des femmes est-elle envisagée différemment de celle des hommes ? La France a-t-elle besoin d’une immigration féminine ? Le genre de l’étranger joue-t-il sur son droit au séjour et au travail ? L’accès à la nationalité française est-il équivalent pour les hommes et les femmes étrangers ?

Par l’étude de milliers de dossiers et de sources diverses et originales, l’auteure, qui travaille avec bonheur les jeux d’échelles - du national au local à travers l’exemple marseillais -, analyse avec finesse des représentations, des politiques, des parcours et des pratiques administratives. Remarquable contribution au savoir sur les migrations dans une perspective genrée, ce livre démontre plus largement qu’une analyse intégrant le genre est incontournable pour mieux comprendre la construction des États-nations et des citoyennetés.
BHLHE40 Mediates Cross-Talk between Pathogenic TH17 Cells and Myeloid Cells during Experimental Autoimmune Encephalomyelitis
Authors: Cook Melissa E , Shchukina Irina , Lin Chih-Chung , Bradstreet Tara R , Schwarzkopf Elizabeth A , Jarjour Nicholas N , Webber Ashlee M , Zaitsev Konstantin , Artyomov Maxim N , Edelson Brian T 
Published: November 2023

Abstract
TH17 cells are implicated in the pathogenesis of multiple sclerosis and experimental autoimmune encephalomyelitis (EAE). We previously reported that the transcription factor basic helix-loop-helix family member e40 (BHLHE40) marks cytokine-producing pathogenic TH cells during EAE, and that its expression in T cells is required for clinical disease. In this study, using dual reporter mice, we show BHLHE40 expression within TH1/17 and ex-TH17 cells following EAE induction. Il17a-Cre–mediated deletion of BHLHE40 in TH cells led to less severe EAE with reduced TH cell cytokine production. Characterization of the leukocytes in the CNS during EAE by single-cell RNA sequencing identified differences in the infiltrating myeloid cells when BHLHE40 was present or absent in TH17 cells. Our studies highlight the importance of BHLHE40 in promoting TH17 cell encephalitogenicity and instructing myeloid cell responses during active EAE.
Study of Attitude and Knowledge toward Sexual Health among Postgraduate Medical Students
Authors: Sawant Neena S. , Singh Rashmi 
Published: November 2023

Background:
The current medical curriculum for both undergraduates and postgraduates is deficient as it does not address the relevant aspects resulting in incomplete training and avoidance of asking about sexual health in routine clinical practice. This research studied the existing knowledge and comfort while taking sexual history, as well as managing the sex-related problems in patients by the medical postgraduates.

Methods:
Two hundred medical residents were recruited in the study after informed consent and ethics approval. Residents in I/II/III years in clinical and nonclinical disciplines were enrolled after systematic sampling. A semi-structured pro forma was used to collect information on knowledge, comfort, and training in sexual health with the help of open and closed-ended questions.

Results:
All knew about menstrual and reproductive health, 70% had knowledge about anatomy and sexual response cycle, 40% about sexual dysfunctions or its treatment. 76% expressed no adequate training was given and 96% felt that the lectures on sexual medicine were less useful. Ninety-one percent wanted training using videotapes, role plays, and group discussions. Sixty-eight percent were comfortable talking about sexual problems to patients of the same sex and 27% to the opposite sex. Ninety-eight percent gave the inability to maintain privacy and confidentiality while sexual history taking in both outpatient and indoor settings.

Conclusions:
Our study has highlighted some of the existing lacunae in the current Indian educational system with regard to sexual health, the existing knowledge and comfort of the postgraduates. More studies and research should be conducted to support the evidence. Curriculum changes with importance to sexual health and increased training can further be considered.
Nomophobia and Its Association with Stress and Coping Styles among Undergraduate Students of a Medical College in New Delhi: A Brief Analysis
Authors: Gupta Dimple , Bhardwaj Akansha , Prakash Rashmi , Jose Nimmi A. , Singh Farishta Hannah D. 
Published: November 2023

Background:
Nomophobia or “No Mobile Phone” phobia is the fear of being detached from one’s own mobile phone. Smartphones have been proven to have numerous advantages in recent times. However, on their excessive use, it can have physical, psychological, behavioral, social, and affective effects. Since the younger generation are the latest buyers of the mobile phones, and the under-25-year age group in professional colleges like medical colleges use mobile phones quite frequently, this study was conducted to find out the prevalence of nomophobia and its association with the coping styles and the perceived stress in undergraduate medical students of a medical college in New Delhi.

Methodology:
The study was a cross-sectional study conducted for 3 months (November 2022–January 2023) on M. B. B. S students. A total of 200 students were selected by purposive sampling. The data was collected using questionnaires. Nomophobia was assessed through Nomophobia Questionnaire. Coping and stress were assessed using Brief Cope and Perceived stress scales, respectively. Data were collected and analyzed using Microsoft Excel 2010 and SPSS software Version 21 (Statistical Package for the Social Sciences, IBM Corp, USA).

Results:
The study was conducted on a total of 197 students undergraduate MBBS students. The prevalence of nomophobia was found to be 99.5% which was higher among females (56%) than males (44%). Among the students with mild (24%) and moderate nomophobia (60%), problem-focused coping mechanism was the most commonly used coping mechanism. Those with severe nomophobia (15%) were found to lean more toward emotion focused followed by problem-focused coping mechanism. A statistically significant association was found between nomophobia and perceived stress.

Conclusions:
Smartphones have many benefits when used for their intended purpose but when used in a problematic way and excessively, they can cause various problems. The higher prevalence of nomophobia among medical students is an issue of concern and has possibly affected their mental health. Strategies are to be devised on a priority basis for minimizing nomophobia among the medical students.
Polydactyly and Single Umbilical Artery
Authors: Rustogi Deepika 
Published: November 2023

Background:
Beckwith–Wiedemann syndrome (BWS) is the most common genetic overgrowth syndrome characterized by the triad of macroglossia, macrosomia, and abdominal wall defects.

Clinical Description:
We report the case of a term baby girl who was born with mesoaxial polydactyly of her left foot. There were no significant antenatal events or exposure to teratogens, although a single umbilical artery (SUA) had been detected on antenatal ultrasonography. There was no evidence of in utero growth retardation. The birth weight was 3.3 kg and the perinatal transition was uneventful. The general physical and systemic examination was otherwise remarkable. Targeted search for concealed major anomalies was negative and the baby was discharged as nonsyndromic polydactyly, emphasizing the need for regular vigilant surveillance on follow-up. At 6 weeks, significant hypertrophy of the left lower limb was noted. This led the direction of evaluation toward lateralized overgrowth syndromes.

Management:
The application of the diagnostic algorithm prompted us to order first-tier genetic testing by methylation-specific multiplex ligation-dependent probe amplification assay. This identified aberrant DNA methylation in the chromosome 11p15 region, establishing the diagnosis of BWS. SUA and polydactyly have not been reported in combination in BWS earlier.

Conclusions:
Neonates with minor anomalies should always have a detailed physical examination at birth and be actively evaluated for major concealed anomalies. Since many clinical manifestations become apparent with age, it is vital that affected babies be kept under close surveillance. A rationale, individualized, step-wise approach with multidisciplinary teamwork helps in establishing the diagnosis in infants with dysmorphic features.
Cerebral Vasculitis in a Case of Henoch–Schönlein Purpura
Authors: Chaudhuri Indrasish Ray , Bhaskar Vikram , Aggarwal Anju , Sharma Sonal 
Published: November 2023

Background:
Henoch–Schönlein purpura (HSP) is the most common vasculitis seen in children that rarely involve central nervous system (CNS) (0.65%–8%). Patients with CNS vasculitis may present with symptoms such as headache, seizures, focal neurological deficit, or behavior abnormalities. We describe a case of HSP where the patient presented with developmental delay along with skin rash and renal involvement.

Clinical Description:
A 15-month-old boy presented with a history of developmental delay and skin rashes for the past 2 months. There was no significant antenatal or birth history. At the age of 15 months, the child could not sit without support, could not transfer objects from one hand to other, could only speak bisyllables, and could not wave “bye-bye.” On examination, the patient had normal vitals with equal volume peripheral pulses and normal blood pressure in all four limbs. Urine examination showed microscopic hematuria, and kidney functions were mildly deranged. Skin biopsy showed immunoglobulin A vasculitis. Magnetic resonance imaging brain was done which revealed multifocal areas of altered signal intensity in periventricular deep white matter in bilateral frontal and parieto-occipital lobes, appearing hyperintense on T2-weighted and fluid-attenuated inversion recovery sequences, showing evidence of diffusion restriction, suggestive of areas of acute ischemia. The findings were consistent with manifestations of CNS vasculitis.

Management:
The patient was managed conservatively and advised physiotherapy and follow-up for developmental delay.

Conclusion:
HSP can rarely involve CNS, however, developmental delay in HSP has never been reported before.
Desaturation during Feeding in a Term Neonate Due to 20P Duplication Syndrome
Authors: Karthikeyan Kadirvel , Natarajan Chandra Kumar , Ramachandran Sumathisri 
Published: November 2023

Background:
Feeding problems are common in preterm neonates of which desaturation during direct feeding is a known entity. However, term newborns have acceptable range of fall in saturation while feeding directly. Here, we report a term newborn with dysmorphic features had desaturation during feeding.

Clinical Description:
A male baby born to second-degree consanguineous parents at term who was managed for transient tachypnea of newborn had fall in saturation beyond acceptable range during feeding. He had low set ears, high-arched palate, thin upper lip, clinodactyly, and anal tag.

Management:
The baby was subjected for thorough exploration of respiratory/gastrointestinal/neurological systems which did not reveal attributable findings. Clinical exome sequencing revealed 20p duplication. He was started on orogastric feeding and could be gradually changed to direct feeding at 4 months of age.

Conclusions:
This report may improve the understanding toward approach to feeding problems in term neonates and also about phenotypic features of 20 p duplication which is less reported.
Linezolid-Induced Ringed Sideroblastic Anemia and Thrombocytopenia in a Child with Extensively Drug-Resistant Tuberculosis
Authors: Sippy Snigdha , Nisal Amit , Sarangi Bhakti U 
Published: November 2023

Background:
With the ever-evolving guidelines and changing drug regimens for pediatric tuberculosis (TB), it is paramount for treating physicians to understand the efficacy and safety profiles of the drugs being used. Linezolid is included in the treatment of multidrug-resistant and extensively drug-resistant (XDR) TB in the intensive, as well as continuation phases.

Clinical Description:
A 12-year-old child with XDR central nervous system TB was treated with second- and third-line anti-tubercular drugs including linezolid. Three weeks after therapy started the boy presented with progressive pallor for a week, lethargy for few days, and rapid breathing since that morning. He was severely pale, acidotic, and in hypotensive shock. Investigations revealed severe anemia, thrombocytopenia, reticulocytopenia, normal liver and renal function, and no evidence of sepsis. He also had severe metabolic acidosis and hyperlactatemia.

Management:
The child was mechanically ventilated and administered red blood cell and platelet transfusions. The presence of ringed sideroblasts in the bone marrow confirmed acquired sideroblastic anemia. The clinical, hematological, and metabolic toxicities were considered most likely due to linezolid. It was discontinued and his drug regime was modified. There was a rapid symptomatic improvement with supportive therapy and gradual increase in hematological parameters with cessation of linezolid.

Conclusions:
Clinicians are used to treating Gram-positive infections with short courses of linezolid. Regular and planned monitoring is required when linezolid is used at higher doses and longer durations.
Laparoscopic Surgical Management of a Gastric Dumbbell Teratoma
Authors: Ananthakrishnan Nanditha , Agarwal Prakash , Satheesa Radhakrishnan 
Published: November 2023

Background:
Teratomas are totipotent tumors commonly seen in gonadal and extragonadal region. Gastric teratomas are very rare and account for <1% of the cases. Conventionally, the treatment of gastric teratoma is open excision of the tumor. We present a rare variant of a gastric teratoma managed laparoscopically.

Clinical Description:
An 8 months' old male was noted to have pallor and history of blood-tinged spit-ups. The child was worked up for the cause of anemia with an upper gastrointestinal disorder as the first differential. The child had significant anemia with a hemoglobin level of 6 g/dl and was transfused packed red blood cells sequential imaging with an abdominal ultrasound, contrast-enhanced computerized tomographic scan, and magnetic resonance imaging identified the presence of a gastric teratoma with both an intragastric and extragastric component (dumbbell variant). He was referred to the pediatric surgery services for further management.

Management:
The infant underwent a gastroscopy to further define the intragastric component of the mass. This revealed a sessile submucosal polypoidal lesion with multiple areas of erosions in the region of the fundus. A biopsy from this suggested a teratoma. The child underwent a total laparoscopic excision of the lesion and recovered well. The histopathology of the tumor was consistent with a mature cystic teratoma (Grade 0). The postoperative period was uneventful.

Conclusion:
Laparoscopic complete surgical excision of the dumbbell variant of gastric teratoma in this child was curative, reduced morbidity, and hospital stay compared to usual open surgery.
A Rare Case of Factor XIII Deficiency Presenting with Scrotal Hematoma in an Adolescent
Authors: Kulkarni Rajesh K. , Vartak Sagar , Karandikar Niharika , Kinikar Aarti 
Published: November 2023

Background:
Factor XIII deficiency is a rare disorder that may be congenital or acquired and is considered if a coagulation disorder is suspected, but the initial laboratory investigations are normal.

Clinical Description:
A 10-year-old boy presented with a scrotal swelling and pain following minor trauma. Local examination showed redness of overlying scrotal skin with tenderness on palpation.

Management:
Initial laboratory investigations for coagulation (prothrombin time/activated partial thromboplastin time/thrombin time) were normal. The diagnosis of factor XIII deficiency was clinched by abnormal clot solubility test. Child was treated with fresh-frozen plasma.

Conclusion:
Scrotal hematoma is a rare site for bleeding in factor XIII deficiency, which must be suspected if clinical suspicion of coagulation disorder is high and initial laboratory tests for coagulation are normal.
Subacute Sclerosing Panencephalitis in Indian Children Under 5 Years during the COVID Pandemic
Authors: Kapoor Dipti , Kakkar Vanshika , Narayana Yerraguntla Venkata , Garg Divyani , Mukherjee Sharmila Banerjee 
Published: November 2023

Background:
Subacute sclerosing panencephalitis (SSPE) is a progressive neurodegenerative disorder of children and young adults. In the setting of the COVID-19 pandemic, we have observed increasing admissions of SSPE and a change in the clinical profile, mainly younger age of presentation, i.e., children under the age of 5 years.

Clinical Description:
We presented the clinical and investigational characteristics of 20 children who were diagnosed as SSPE during the period March 2020–March 2021 in our hospital, based on the Dyken criteria. The mean age was observed to be 3 years 9 months and male-to-female ratio of 1:1. Most children presented with developmental regression and myoclonic jerks. The clinical details and investigations were presented and a few atypical cases were discussed.

Management:
All the patients were treated symptomatically: anticonvulsant drugs, nutritional rehabilitation and supported feeding, occupational therapy, and palliative therapy. A trial of isoprinosine was started in all the patients, but was discontinued by most due to the expense. There were no mortalities.

Conclusion:
The change in profile of SSPE to an earlier onset in the setting of the pandemic should make the clinician keep a high index of suspicion of this disorder in children under the age of five years who present with unexplained developmental regression or acute encephalopathy, before the onset of typical myoclonus.
Acute Intravascular Hemolysis in the Critical Phase of Severe Dengue
Authors: Ghosh Sonali , Mahajan Lokesh 
Published: November 2023

Background:
Dengue and severe dengue have various hemorrhagic manifestations ranging from mild presentations such as petechiae, bleeding from injection sites, ecchymosis, and gum bleeding to severe presentations like major mucosal bleeding such as hematemesis, melena, menorrhagia, and concealed internal bleeding. Common causes of anemia in dengue are due to blood loss (secondary to thrombocytopenia and/or coagulopathy), transient suppression of the bone marrow, and rarely, hemolytic anemia.

Clinical Description:
We describe a 5-year-old boy who presented to us in the critical phase of severe dengue with features of capillary leakage and cola-colored urine. Salient investigation reports were anemia, thrombocytopenia, normal reticulocyte count, absence of coagulopathy, indirect hyperbilirubinemia, deranged transaminase, highly elevated lactate dehydrogenase, and low haptoglobin levels, and hemoglobinuria, suggestive of acute intravascular hemolysis (AIVH). Autoimmune and microangiopathic hemolytic anemia, malaria, ingestion of dyes, snake bite, Glucose 6 phosphate dehydrogenase deficiency, and incompatible blood transfusions were excluded. Thus, the final diagnosis was severe dengue with hemolytic anemia and AIVH.

Management:
Oxygen delivery by the Heated Humidified High-Flow Nasal Cannula, strict input/output charting, appropriate fluid therapy, and diuretic infusion were the mainstays of management in an intensive setting. The aim was to maintain ventilation, perfusion, balance hydration, achieve optimal urine output and prevent fluid overload.

Conclusion:
Clinicians should consider Dengue as a possible cause for AIVH in children with severe dengue and cola-colored urine.
Targeted Breast Milk Modification
Authors: Patra Saikat , Bhisikar Swapnil , Kalamdani Pavan , Kalathingal Thaslima 
Published: November 2023

Background:
The management of urea cycle disorders (UCDs) needs use of nitrogen scavenger drugs and protein restricted special formulas. The latter is not easily accessible and expensive. Continued breastfeeding is poorly tolerated by most babies. In these circumstances, targeted breast milk modification can be lifesaving by reducing ammonia and preventing a catabolic state.

Clinical Description:
A term baby born by normal delivery was discharged at 48 h after successfully initiating breastfeeding. He developed lethargy, poor feeding, and seizures on the 4th day. Vitals were stable. Sepsis, hypoglycemia, hypoxic-ischemic encephalopathy, dyselectrolytemia, hepatic/renal derangement, structural brain anomalies, cerebral edema, and hemorrhage were ruled out. A UCD was suspected due to hyperammonemia without acidosis. Citrullinemia was established by elevated citrulline and no orotic acid.

Management:
Breastfeeding was stopped, nitrogen scavenger drugs started, and peritoneal dialysis performed. As specialized milk formula was unavailable, we started diluted breast milk mixed with corn starch and coconut oil to achieve protein restriction and provide appropriate carbohydrates, lipids, and energy. Dilution was gradually decreased. There was gradual improvement in sensorium with normalization of ammonia. The baby was well till 8 weeks but developed symptomatic hyperammonemia due to noncompliance with therapy.

Conclusion:
Targeted modification of breast milk may be the only viable option for feeding infants with UCD in extraordinary circumstances. However, its short- and long-term consequences need to be researched thoroughly.
Opaque Hemithorax in a Child
Authors: Kumar Ketan , Mathew Joseph L. , Muralidharan Jayashree , Singhal Kamal K. , Sodhi Kushaljit S. , Vaidya Pankaj C. , Singh Meenu 
Published: November 2023

Background:
Children with acute febrile respiratory illnesses are commonly seen in the emergency department. Apart from the initial stabilization, they need to be assessed for the underlying cause, and clinicians should formulate differential diagnoses to start treatment. Radiological investigations including x-ray and ultrasonography are often used to narrow down the initial possibilities based on history and examination. A child presenting with an opaque hemithorax is one such scenario.

Clinical Description:
A 3-year-old boy presented with a short duration of fever, cough and respiratory distress. Examination showed rightward mediastinal shift with dull percussion note and reduced breath sounds over the left hemithorax, along with congested neck veins, stridor and left sided wheeze. Chest x-ray showed an opacified left hemithorax and ultrasonography suggested moderate pleural effusion.

Management:
Complicated pneumonia with parapneumonic effusion (or empyema) was considered, but a diagnostic pleural tap was dry. The possibilities were revised to include cystic space occupying lesions with mediastinal compression. Computed tomography of the chest confirmed a mass lesion with predominantly cystic components. The patient underwent surgical excision, and histopathology showed pleuropulmonary blastoma.

Conclusion:
Although respiratory infections are common in childhood, clinical evaluation and judicious use of imaging modalities can uncover less common conditions. Although bedside ultrasonography is a handy tool in the emergency department, it is not infallible.