bluuebunny/crossref_metadata_2025 huggingface dataset:
Broken Pots, Mended Dreams: Concepts, Causes, and Effects of Teenage Pregnancy in Outreach Barangay
Authors:   University of San Agustin, Iloilo City, Philippines, Solar Nick John
Published: January 2025

This study aimed to determine the concepts, causes and effects of teenage pregnancy among selected residents in outreach barangay as an entire group and when classified as to sex. Mixed descriptive and phenomenological methods of research were used, utilizing 50 selected residents as respondents, 7 or 14% were male and 43 or 86% were female, whom were selected through random sampling. The data were obtained through the use of a survey questionnaire. Based on the findings, results revealed that when respondents were categorized by the entire group, teenage pregnancy was the transition period between childhood and adulthood, while, incident of teenage pregnancy was high and was avoided in the outreach barangay were the least concepts of teenage pregnancy exist. The top cause of teenage pregnancy was lack of sex education while, the least cause of teenage pregnancy was the socio-economic status. The effect of teenage pregnancy was primarily an incomplete education and the least effect will be isolation and rejection of friends or community. Furthermore, no significant differences and relationship on the concepts, causes and effects of teenage pregnancy resulted among selected residents in outreach barangay.

Lived Experiences among Respondents of Teenage Pregnancy were divided into subthemes: (a) socio-economic status (b) health and (c) family relationship. Coping to Survive the Dilemmas of Teenage Pregnancy were divided into subthemes: (a) family support and (b) prayers and believing to the help Most Powerful Almighty.

Statistical treatments were mean, standard deviation and t-test for independent samples set at 0.05 alpha level. All computations were done via SPSS software.
Militarization of artificial intelligence and implications for the global security – A strategic theory perspective
Authors: Niazi Lal Khan
Published: January 2025

Artificial intelligence is quoted as the revolutionary development that attracted the attention of a diverse range of domains. It is considered as the general-purpose technology that experts integrated with their respective domains. Likewise, militaries attempted to militarize the artificial intelligence in order to score relative gains in contrast to other states. Military application of artificial intelligence evolves warfare; introduces autonomous weapons; optimizes logistics; and enable AI technologies in intelligence, surveillance, reconnaissance and trainings. The implications of militarization of artificial intelligence are multifaceted and highlights risks associated with it. The risks involve arms race, ethical concerns, accidental conflicts, and influence of commercial companies in the defense sector. Strategic theory has been taken as a theoretical framework to comprehensively understand the research problem. Strategic theory is proposed as the comprehensive approach providing holistic thinking to the defense communities regarding the management of state’s resources in the pursuit of achieving policy ends. The militarization of artificial intelligence takes into account the advance technologies of AI and integrate them with the military domain to score advantage in the battlefield. Militaries are investing state resources in such a manner that integrate artificial intelligence with the military domain to score superiority among great powers.
Pembunuhan Berantai Remaja : Analisis Profil Psikologis dan Kriminologis
Authors: Monika Reska
Published: January 2025

Pembunuhan berantai ialah jenis kejahatan kekerasan tertentu yang termasuk dalam kategori kejahatan multisida sesuai dengan nomenklatural manual klasifikasi pada kejahatan kekerasan Biro Investigasi Federal, Sebagian besar pembunuhan berantai pelakunya ialah orang dewasa. Namun, dalam jumlah yang lebih kecil, pembunuhan berantai juga dilakukan oleh generasi muda. Pembunuhan berantai muda adalah topik yang relevan di berbagai bidang seperti psikologi, krimonologi, dan sistem peradilan. sangat dibutuhkan penelitian tambahan karena penelitian in masih sangat jarang dibahas khususnya di Indonesia mengenai pembunuhan berantai dan belum mencapai kesimpulan mengenai faktor-faktor yang dapat mempengaruhi kriminalitas multisida. Pembunuhan yang dilakukan oleh anak-anak dan remaja menunjukan situasi sosial yang memperihatinkan mengingat usia mereka yang relative muda. Meskipun statistik resmi menunjukan bahwa pembunuhan berantai remaja jarang terjadi. Namun, beberapa hasil riset menyatakan bahwa pembunuhan pertama jenis ini sering terjadi pada remaja. Penting untuk mempertimbangkan psikopati sebagai faktor yang berpengaruh dalam berbagai jenis tindak pidana berantai yang dilakukan oleh anak-anak remaja. pentingnya untuk merencanakan intervensi khusus yang berfokus terhadap kebutuhan untuk menggali manifestasi kriminal berantai yang tentunya perlu disoroti untuk dapat menjawab dalam penelitian dimasa depan.
 
Kata kunci : Pembunuhan berantai ; remaja; profil ; psikopati
Menghitung Biaya Psikologis Litigasi Perceraian Bagi Perempuan Penggugat
Authors: Nisa Haiyun , Koentjoro  , Nasution Khoiruddin
Published: January 2025

Litigation is the process of resolving several dispute cases through the courts, including divorce cases. The divorce litigation process is a series of processes for resolving the breakdown of the husband and wife's marital relationship, which is determined by a permanent legal decision. The Supreme Court has issued Regulation Number 3/2017 on Guidelines for Adjudicating Women Against the Law, but there are still several problems experienced by women in the legal process. As plaintiffs, women must pay several court fees when filing a divorce case through court.  Apart from a certain amount of legal costs, it turns out that women also incur significant psychological costs when participating in the litigation process. How and how much psychological cost do women incur? This research explores women’s experiences suing for divorce regarding the psychological costs incurred during the litigation process. Five female plaintiffs participated in semi-structured interviews. The findings of this study indicate that the psychological costs incurred during the divorce litigation process include ignorance of the divorce legal process, anxiety about facing the trial process in court, fear of facing the husband during the trial in court, and emotional and relational difficulties. The psychological costs of litigation can affect the psychological well-being of women who file for divorce, so efforts are needed to minimize the psychological costs of the litigation process with the involvement and collaboration of all parties. It is hoped that the results of this research can help policymakers design litigation processes that minimize high psychological costs.
Korean Red ginseng enhances ZBP1-mediated cell death to suppress viral protein expression in host defense against Influenza A virus
Authors: Oh Jueun , Kim Hayeon , Lee Jihye , Kim Suhyun , Shin Seyun , Kim Young-Eui , Park Sehee , Lee SangJoon
Published: January 2025

Korean Red ginseng has emerged as a potent candidate in the fight against various viral infections, demonstrating significant efficacy both in vitro and in vivo, particularly against influenza A viruses. Despite substantial evidence of its antiviral properties, the detailed molecular mechanisms through which it reduces viral lethality remain insufficiently understood. Our investigations have highlighted the superior effectiveness of Korean Red ginseng against influenza viruses, outperforming its effects on numerous other viral strains. We aim to uncover the specific mechanisms by which Korean Red ginseng exerts its antiviral effects, focusing on influenza A viruses. Our prior studies have identified the role of Z-DNA-binding protein 1 (ZBP1), a signaling complex involved in inducing programmed cell death in response to influenza virus infection. Given the critical role of ZBP1 as a sensor for viral nucleic acid, we hypothesize that Korean Red ginseng may modulate the ZBP1-derived cell death pathway. This interaction is anticipated to enhance cell death while concurrently suppressing viral protein expression, offering novel insights into the antiviral mechanism of Korean Red ginseng against influenza A viruses.
Lactic acid bacteria from Ethiopian traditional beverage, Tella: technological and metabolic profiles for industrial application
Authors: Yehuala Gashaw Assefa , Choe Jaein , Shibeshi Nurelegne Tefera , Delessa Kumsa , Desalegn Asnake , Park Mi-Kyung
Published: January 2025

Tella is a traditional beverage widely accepted by consumers, despite the lack of product consistency owing to its reliance on natural fermentation. This study aimed to identify potential industrial lactic acid bacteria (LAB) starter cultures based on their technological properties. Seven LAB strains isolated from Tella were characterized for their carbohydrate utilization, salt content, temperature, and acid tolerances, growth and acidification rates, and metabolite profiles. Most strains efficiently utilized various carbohydrates, with Lactiplantibacillus plantarum TDM41 showing exceptional versatility. The strains exhibited similar growth characteristics. Principal component analysis of stress tolerance properties revealed that L. plantarum TDM41, Pediococcus pentosaceus TAA01, and Leuconostoc mesenteroides TDB22 exhibited superior tolerance ability. Strong acidification properties were detected in the L. plantarum TDM41, P. pentosaceus TAA01, and Leuconostoc mesenteroides TDB22 strains after 24 h incubation at 30°C. L. plantarum TDM41 displayed the fastest acidification rate throughout the analysis period. All LAB strains produced significant amounts of diverse organic acids, including lactic acid, citric acid, acetic acid, malic acid, and succinic acid, with lactic acid being the primary acid produced by each strain. Overall, strains L. plantarum TDM41 and P. pentosaceus TAA01 prove to be potential candidates for Tella industrial starter cultures and similar cereal products owing to their robust technological properties.
Effects of housing conditions on behaviour and physiology in the Finnraccoon (Nyctereutes procyonoides ussuriensis)
Authors: Koistinen T , Moisander-Jylhä A-M , Korhonen HT
Published: January 2025

The welfare of juvenile Finnraccoons (Nyctereutes procyonoides ussuriensis) was compared between various housing conditions through the measurement of day-time behaviour and physiological variables. For the small control treatment (SC), Finnraccoons were raised in pairs in small cages; in the large area treatment (LA), in pairs in large cages; in the large control treatment (LC), in groups of four in large cages and in the large enrichment treatment (LE), in groups of four in large cages with access to a nest-box and a large tube, from weaning to pelting time. Study subjects consisted of a total of 152 Finnraccoons. As autumn progressed, day-time resting increased, especially allohuddling; while active behaviours decreased. Allohuddling was the most common type of resting; apart from in the LE treatment, resting shelters were used effectively alongside allohuddling. Locomotion was observed more frequently in LA and LC treatments, ie in large cages without shelters. The nest-box roof was preferred to the platform as an elevated location, and the nest-box to the tube as a resting shelter. Agonistic interactions were not observed. Males grew heavier than females and had heavier organs. No systematic differences in haematological and other physiological parameters were found between the treatments. Catching time was shortest in the SC treatment. The LE treatment compromised animals’ cleanliness. Based on the intensive positive social interactions and regular shelter use, group housing and access to resting shelters are recommended for juvenile Finnraccoons.
A new method for constructing pyrido[3',2':4,5]imidazo[1,2-b]pyridazine system and preparation of its derivatives
Authors: Zubenko Alexander A , Sochnev Vadim S , Morkovnik Anatolii Savel'evich , Divaeva Lyudmila N , Burlov Anatolii Sergeevich , Svyatogorova Alexandra E , Avagyan Elen N
Published: January 2025

A new method for the construction of the pyrido[3',2':4,5]imidazo[1,2-b]pyridazine system involves the use of 2-chloro-3-nitropyridine and 6-chloropyridazin-3(2H)-one as the starting reactants. The key step is the POCl3-promoted cyclization of the intermediate 2-(3-aminopyridin-2-yl)-6-chloropyridazin-3(2H)-one. The 2-positioned chlorine atom in the thus obtained 2-chloropyrido[3',2':4,5]imidazo[1,2-b]pyridazine can be replaced by a variety of nucleophiles.
Cyclodextrin increases the effectiveness of albumin’s interaction with antibacterial drugs and their combinations
Authors: Skuredina Anna A , Kudryashova Elena Vadimovna
Published: January 2025

Fluorescence studies indicate that a two-drug combination demonstrates the synergism in binding to human serum albumin if drugs prefer different protein binding sites. The formation of a drug complex with methylated β-cyclodextrin leads to an increase in albumin’s quenching and drug binding affinity, while the fluorescence quenching mechanism remains unchanged.
Synthesis and antimicrobial activity of mono- and bisphosphonium salts based on tertiary phosphines and ethyl bromoacetate
Authors: Romanov Semyon R. , Orlova Olga V. , Shulaeva Marina P. , Pozdeev Oskar K. , Fedonin Anton P. , Ivshin Kamil A. , Kataeva Olga N. , Galkina Irina V. , Bakhtiyarova Yulia V.
Published: January 2025

The nucleophilic substitution reaction between tertiary phosphines and ethyl bromoacetate affords the quaternary EtOC(O)CH2-substituted phosphonium salts. In the cases of bisphosphines, the corresponding bisphosphonium salts are formed. The synthesized phosphonium compounds were evaluated for in vitro antimicrobial activity.
A chemical approach for probing the interphase boundary between polymer electrolyte membrane and HT-PEM fuel cell carbon nanofiber anode
Authors: Ponomarev Igor I. , Volkova Yulia A. , Skupov Kirill M. , Vtyurina Elizaveta S. , Ponomarev Ivan I.
Published: January 2025

Interphase boundary interactions are essential for high-temperature polymer electrolyte membrane fuel cell membrane electrode assembly (MEA) operation. Interactions between the self-phosphorylating polybenzimidazole (PBI)-6F coating on a carbon nanofiber electrode and the self-phosphorylating proton-conducting membrane during MEA operation would improve the cell performance. The presented approach represents a novel path for the development of a PBI membrane-based MEA.
Highly regioselective synthesis and structure of 1-substituted 3a,6,6a-triphenylglycolurils
Authors: Baranov Vladimir Vladimirovich , Antonova Maria M. , Aksenova Svetlana A. , Kolotyrkina Natalya G. , Kravchenko Angelina Nikolaevna
Published: January 2025

The reactions of 1-alkyl-5-hydroxy-4,5-diphenyl-1,5-di-hydro-2H-imidazol-2-ones or 7-hydroxy-7,7a-diphenyltetrahydroimidazo[5,1-b][1,3]oxazol-5(6H)-one with 1-phenylurea selectively afford new 1-substituted 3a,6,6a-triphenylglycolurils. Crystals of four representatives were studied by X-ray diffraction when the formation of two conglomerates was discovered.
Synthesis and structure of trinuclear yttrium(III) dihydrido cluster stabilized by bulky amidinate ligand
Authors: Lyubov Dmitry Mikhailovich , Cherkasov Anton V , Trifonov Aleksandr Anatol'evich
Published: January 2025

A new yttrium dihydride complex [(AmdBut)Y]3(μ-H)6(THF)2 (AmdBut = [ButC(NC6H3Pri2-2,6)2]−) was synthesized by the reaction of (AmdBut)Y(CH2SiMe3)2(THF) with two molar equivalents of PhSiH3. This complex adopts a trinuclear structure both in crystalline state and in C6D6 solution due to five μ2- and one μ3-bridging hydride ligands. The complex was found to be active in hydrosilylation of terminal alkenes with PhSiH3.
Influence of the anion ratio in the composition of mixed benzoate/pentafluorobenzoate complexes of europium on the structure and photoluminescent properties
Authors: Shmelev Maxim A. , Levina Anastasia A. , Chistyakov Aleksandr S. , Varaksina Evgeniya A. , Voronina Julia K. , Razgonyaeva Galina A. , Taidakov Il'ya Viktorovich , Sidorov Alexey A. , Eremenko Igor Leonidovich
Published: January 2025

Mixed carboxylate benzoate (bz)/pentafluorobenzoate (pfb) complexes with different ratios of pfb and bz anions in the {Eu(EtOH)2(pfb)(bz)2}n and {Eu(EtOH)(pfb)2(bz)}n compositions were obtained and structurally characterized. Changes in the pfb/bz ratio lead to changes in the geometry of the polymer chains and the lanthanide polyhedron, as well as to a rearrangement of the system of non-covalent interactions, which also affects the photoluminescent properties. The synthesized compounds were characterized by X-ray diffraction study, IR spectroscopy and CHN analysis; non-covalent interactions were analyzed using Hirshfeld surface analysis.
One-pot synthesis of pyrrolooxazoles from pyrrolyl acetylenic ketones and natural aldehydes
Authors: Tomilin Denis Nikolaevich , Stepanova Sophia A , Sobenina Lyubov Nikolaevna , Oparina Ludmila A , Ushakov Igor Alekseevich , Trofimov Boris Aleksandrovich
Published: January 2025

Natural aldehydes and some of their derivatives undergo base-catalyzed [3 + 2]-cyclization with pyrrolyl acetylenic ketones in a click-like manner (Et2O, KOH, room temperature) to afford pyrrolo[1,2-c]oxazoles in up to 77
Managing the Past and the Future
Authors: Klareld Ann-Sofie , Pihl Skoog Emma , Söderström Kristofer
Published: January 2025

This paper focuses on contemporary archival professionals in Sweden. The research questions posed are: RQ1: What are the different facets of archival work commonly described in employment advertisements directed at archival professionals? RQ2: What are the desirable personal traits that employers seek when hiring an archival professional?  The material consists of job advertisements from the year 2022 compiled from Historical ads. The methods applied are content analysis and reflexive thematic analysis, and we use the term archival professionals to denote employees that are responsible for society's information resources being created, shared, used and preserved in an adequate way. A well-functioning information supply is crucial for information security, transparency and public access to information, and for securing future digital cultural heritage. Archival professionals have often been described as somewhat mysterious and obscured. Due to digitalisation, new demands are being created. However, it is not self-evident what different facets of archival work are required and what personal characteristics are beneficial. Our conclusion is that there is a broad scope in the types of archival work described and wished by employers. The roles and responsibilities of archival professionals, as depicted in employment advertisements, are diverse and multifaceted. They are expected to develop, lead, and educate within their area of expertise. Personality wise, an archival professional should be meticulous and at the same time flexible, be prepared to do monotonous work but also be creative, be able to work alone and at the same time meet the public.
Techniques and Social Functions of the Graphic Documentary Style: How Japanese Manga Depicts Health-Related Social Issues
Authors: Nakagaki Kotaro
Published: January 2025

Graphic documentaries “visually narrate and represent aspects and events of the real world” (Mickwitz, 2014, p. 2). Two noted examples include Joe Sacco’s comics journalistic work, Palestine (2001) and Marjane Satrapi's autobiographical graphic memoir during and after the Islamic revolution, Persepolis (2000-03). The field of animated documentary, a moving image that combines animation and documentary, has also been growing in popularity in the digital age. 
Recently, some Japanese medical manga works have been introducing “graphic documentary” techniques. Some of these works interweave fiction and actual experiences gathered through in-depth interviews with medical professionals or patients. Another example is work that devises a unique style of calling for anecdotes via social media to create manga stories. Using semi-documentary methods, skillful professional artists can address delicate topics in the medical field from various perspectives and under a range of themes. 
This conference paper will analyze three categories of graphic documentaries from Japanese manga artists in the realm of graphic medicine (the intersection between the medium of comics and the discourse of healthcare (Czerwiec et al., 2015)). Additionally, the question of how manga media can effectively address medical themes will be reconsidered.
Preparation and characterization of bacterial cellulose film using coconut water and Lentilactobacillus parafarraginis by the casting method
Authors: Ningsih Indah Yulia , Hidayat Mochammad Amrun , Kuswandi Bambang , Erawati Tristiana
Published: January 2025

Bacterial cellulose (BC) is a natural biomaterial formed by bacteria. It has distinctive properties and enormous utilization in various fields. The present study focused on BC film preparation using Lentilactobacillus parafarraginis and coconut water as a fermentation medium. This study aimed to characterize BC with variations in coconut water storage and fermentation time. The coconut water was kept for 1 and 2 days, then fermented for 5, 7, and 9 days. The dry BC film was produced by the casting method. Besides characterization, BC films were also analyzed for their morphology based on Fourier transformed infra-Red, X-ray diffraction spectra, scanning electron microscopy, and atomic force microscopy images. The result showed that BC film with 2 days storage time of coconut water and 9 days fermentation time (BC29) possessed the best properties. It exhibited high wet weight (126.50 ± 0.24 g) and wet thickness (6.83 ± 0.18 mm) with pH, water vapor transmission, and moisture content value of 5.89 ± 0.01, 387.81 ± 0.35 g/m2, and 6.12% ± 0.13%, respectively. The BC film showed a high swelling degree (125.64% ± 0.25%) and mechanical strength (tensile strength of 13.52 ± 0.01 mPa, elongation at break of 35.81% ± 0.03%, and Young’s modulus of 99.08 ± 0.04 mPa). The result suggested that BC film can be developed as a new biomaterial with lower cost and better properties than existing films.
Annihilation of action potentials induces electrical coupling between neurons
Authors: Schlötter Moritz , Maret Georg , Kleineidam Christoph J
Published: January 2025

Neurons generate and propagate electrical pulses called action potentials which annihilate on arrival at the axon terminal. We measure the extracellular electric field generated by propagating and annihilating action potentials and find that on annihilation, action potentials expel a local discharge. The discharge at the axon terminal generates an inhomogeneous electric field that immediately influences target neurons and thus provokes ephaptic coupling. Our measurements are quantitatively verified by a powerful analytical model which reveals excitation and inhibition in target neurons, depending on position and morphology of the source-target arrangement. Our model is in full agreement with experimental findings on ephaptic coupling at the well-studied Basket cell - Purkinje cell synapse. It is able to predict ephaptic coupling for any other synaptic geometry as illustrated by a few examples.
Cortical tracking of hierarchical rhythms orchestrates the multisensory processing of biological motion
Authors: Shen Li , Li Shuo , Tian Yuhao , Wang Ying , Jiang Yi
Published: January 2025

When observing others’ behaviors, we continuously integrate their movements with the corresponding sounds to enhance perception and develop adaptive responses. However, how the human brain integrates these complex audiovisual cues based on their natural temporal correspondence remains unclear. Using electroencephalogram (EEG), we demonstrated that rhythmic cortical activity tracked the hierarchical rhythmic structures in audiovisually congruent human walking movements and footstep sounds. Remarkably, the cortical tracking effects exhibit distinct multisensory integration modes at two temporal scales: an additive mode in a lower-order, narrower temporal integration window (step-cycle) and a super-additive enhancement in a higher-order, broader temporal window (gait-cycle). Furthermore, while neural responses at the lower-order timescale reflect a domain-general audiovisual integration process, cortical tracking at the higher-order timescale is exclusively engaged in the integration of biological motion cues. In addition, only this higher-order, domain-specific cortical tracking effect correlates with individuals’ autistic traits, highlighting its potential as a neural marker for autism spectrum disorder. These findings unveil the multifaceted mechanism whereby rhythmic cortical activity supports the multisensory integration of human motion, shedding light on how neural coding of hierarchical temporal structures orchestrates the processing of complex, natural stimuli across multiple timescales.
A Case of Renal Pelvi-venous Fistula Diagnosed by Nephrostogram: A Rare Complication of Percutaneous Nephrostomy
Authors: Bakare Vishal Nandkishor , Sahu Ritesh Kumar , Thakur Rohan Rahul , Hiremath Aniketh Davangere
Published: January 2025

Percutaneous Nephrostomy (PCN) is a minimally invasive procedure used in patients with hydronephrosis. Major haemorrhagic complications requiring transfusions occur in 1-4% of PCNs, while major vascular injuries (requiring embolisation or nephrectomy) occur in 0.1-1% of cases. The sources of bleeding are usually from pseudoaneurysms or Arteriovenous (AV) fistulas when the nephrostomy tract passes near the renal hilum. A calyceal-venous or renal pelvi-venous fistula is a rare but significant complication that can arise following PCN, ureteric obstruction, and renal transplantation. Invasive treatment options for managing these fistulae include transvenous embolisation, external drainage to relieve outflow obstruction, and open surgical management, which may involve closure of the fistula, partial nephrectomy, or complete nephrectomy. Hereby, the authors present a case of 74-year-old male patient with carcinoma of the urinary bladder, who had a history of bilateral PCN due to vesico-ureteric junction involvement. He presented post-procedure with continuous haematuria from the left PCN catheter. There was a significant drop in haemoglobin; however, the patient remained vitally stable. A nephrostogram performed by injecting contrast via the PCN catheter revealed a renal pelvis-renal vein (pelvi-venous) fistula. He was managed by placing a pigtail catheter with its tip in the mid-ureter to provide external drainage and a tamponade effect at the fistula site. The haematuria gradually resolved within two days, with clear urine output. Therefore, the authors aimed to draw attention to the rare finding of a renal pelvi-venous fistula on nephrostogram following PCN and its management through the repositioning of the nephrostomy tube.
A 250-kb Microdeletion Identified in Chromosome 16 Is Associated With Non-Syndromic Sensorineural Hearing Loss in a South Indian Consanguineous Family
Authors: Swetha Jayakumar , Sakthignanavel Arulmozhi , Manoharan Aarthi , Rangarajalu Jayakumar , Arunagiri Priyadharshini , Govindasamy Chandramohan , Ravikumar Sambandam
Published: January 2025

Background and Objectives: Hereditary hearing loss is the most common genetic disorder in children. Nearly 120 genes associated with auditory impairment have been identified. Although the disease is clinically and genetically complex, the chances of identifying deafness-causing loci increase when studying consanguineous families.Materials and Methods: Whole-exome sequencing was performed to identify genetic variants underlying sensorineural hearing loss in affected individuals from a family with third-degree consanguineous practices.Results: A homozygous deletion of 250.285 kb was identified in the 16p12.2 region encompassing three genes, METTL9, IGSF6, and OTOA, and a partial deletion of the NPIPB4 gene co-segregated within the family.Conclusions: This study highlighted the genetic heterogeneity of hearing loss in consanguineous families. Future research should focus on the OTOA mutational spectrum in South Indian populations with hearing loss.
Translation, Cross-Cultural Adaptation, and Validation of the Eustachian Tube Dysfunction Patient Questionnaire for Assessing Eustachian Tube Dysfunction in Greece
Authors: Anastasiadou Sofia , Karkos Petros , Constantinidis Jannis , Triaridis Stefanos , Psillas George
Published: January 2025

Background and Objectives: Eustachian tube dysfunction (ETD) is prevalent among patients with ENT disorders, necessitating history-taking, clinical examination, and appropriate investigation for diagnosis. Eustachian Tube Dysfunction Patient Questionnaire (ETDQ-7) is a valuable tool for subjectively assessing symptom severity related to this condition. This study aims to adapt and validate the ETDQ-7 in Greece, ensuring its accuracy and efficacy in outpatient settings.Subjects and Methods: The ETDQ-7 was translated into Greek following established methodology. Data were collected from 75 Greek patients diagnosed with ETD and 25 control patients without ETD. Participants completed the adapted ETDQ-7 and underwent a clinical examination, with statistical analysis correlating with their ETDQ-7 responses. Statistical analyses were performed to determine the questionnaire’s reliability and validity.Results: Internal consistency and item analyses were performed to validate the questionnaire. Face and content validity were confirmed, and patients found the questionnaire easy to administer and complete. Test-retest reliability demonstrated similar internal consistency and a strong correlation between individual items and the total score. Discriminative validity revealed a statistically significant difference between the two patient groups, supporting the usefulness of the Greek version of ETDQ-7 in confirming the diagnosis of ETD.Conclusions: The Greek version of ETDQ-7 proves to be safe and effective for diagnosing ETD in Greek-speaking populations, complementing various investigative methods.
Functional Near-Infrared Spectroscopy Analysis of the Cognitive Functions of Elderly Patients With Hearing Loss
Authors: Lee Seung Jae , Choi Jiwon , Song Hyun Bok , Kyong Jeong-Sug , Lee Sang-Yeon , Lee Jun Ho
Published: January 2025

Background and Objectives: Age-related hearing loss is a modifiable risk factor for mild cognitive impairment (MCI); however, the potential mechanisms linking these conditions remain unclear. Therefore, in this study, we analyzed the cognitive function profiles of elderly patients with hearing loss via functional near-infrared spectroscopy (fNIRS) to determine the cortical activity differences between patients at risk of MCI and those with normal cognition.Materials and Methods: Sixty-three elderly patients with bilateral, moderate, or severe hearing loss were prospectively recruited for this study. Their demographic information was obtained, and audiological evaluations and cognitive function tests were performed. Various instruments were used to assess the cognitive and depression domains. Additionally, fNIRS was used to image the brains of the normal group and group at risk of MCI.Results: fNIRS analysis of individual cognitive task data revealed that the normal group exhibited significantly higher oxygenated hemoglobin (HbO2) levels in all cognitive function tasks, except the Stroop color and word test, than the group at risk of MCI. Detailed comparisons of the Brodmann areas revealed that, compared to the group at risk of MCI, normal group exhibited significantly higher HbO2 levels in the right and left dorsolateral prefrontal cortices, ventrolateral prefrontal cortex, frontopolar cortex, and orbitofrontal cortex in the J1 task, right ventrolateral prefrontal cortex in the J2 task, and right orbitofrontal cortex in the J6 task.Conclusions: Measurement of fNIRS signals in the frontal lobes revealed different HbO2 signals between the normal group and group at risk of MCI during minimal hearing loss. Future studies should explore the causal link between hearing loss and cognitive impairment by analyzing the changes in cognitive function after auditory rehabilitation.
Recurrent Meningitis Following Previous Repair of Congenital Oval Window Defect
Authors: Lim Wan Qi , Seah Cherie Xinyi , Choy Kevin Chi Chuen , Yeo Seng Beng , Lim Jane Peiwen
Published: January 2025

A 19-year-old male patient with a history of congenital left oval window defect has had recurrent admissions to a children’s hospital for bacterial meningitis since the age of 7. Investigations revealed a left-sided type 1 incomplete partition deformity of the left ear with a congenital oval window defect, leading to communication between the cranium and the middle ear. The patient underwent a left canal wall down mastoidectomy and oval window defect repair, remaining well for 3 years. He experienced two more episodes of bacterial meningitis as he got older, prompting repeated exploratory tympanotomy and repair of the cerebrospinal fluid (CSF) leak after each episode. Recently, he was referred again for recurrent meningitis. Investigations showed a recurrent oval window defect. After undergoing left external ear canal transection, mastoid and middle ear obliteration, and left Eustachian tube obliteration, he remained well without further leaks or meningitis. Congenital oval window defect is rare and may present with recurrent bacterial meningitis secondary to spontaneous CSF leak via the oval window. Radiology plays a crucial role in identifying the source of the CSF leak, facilitating more precise preoperative counseling and surgical intervention.
Novel Approach to the Simulator Sickness Questionnaire
Authors: Uğur Emel , Kurter Asime , Aydın Çağla , Konukseven Bahriye Özlem
Published: January 2025

Background and Objectives: Virtual reality (VR) applications change the perception of reality, resulting in a feeling of being in a natural environment. The occurrence of cybersickness (CS) when using VR applications is a well-documented side effect, and the Simulator Sickness Questionnaire (SSQ) has been used to assess CS. Considering the speed of VR technology development, CS will likely become a frequently researched and discussed topics in the near future. Therefore, the aim of this study was to conduct a Turkish validity and reliability study and introduce the SSQ to Turkish medical literature.Materials and Methods: A total of 160 healthy individuals (80 females and 80 males) aged >18 years (28.4±7.2 years) were included in our study. The SSQ was provided to the participants through Google Forms before and after the VR provocation experience and within the scope of the test and retest protocol.Results: The reliability and internal consistency of the questionnaire were observed at a high level (Cronbach’s alpha=0.854, Spearman-Brown coefficient r=0.871). Factor analysis was performed and the questionnaire was divided into three subfactors, consistent with the original questionnaire. In the responses obtained from the participants before and after VR provocation, statistically significant differences were observed in 13 of the 16 items in the questionnaire that are related to VR provocation (p<0.05). Statistically, the differences in fatigue, dizziness, and vertigo were greater in females than in males (p<0.05).Conclusions: The Turkish version of the SSQ is an effective tool for measuring the side effects in VR environments. The inclusion of the SSQ in the Turkish literature enables the inclusion of non-English-speaking participants in research, especially for disciplines that consider peripheral and central vestibular disorders.
Update on Medical Management of Acute Peripheral Facial Palsy
Authors: Kim Sang Hoon , Kwak Min Young
Published: January 2025

Acute facial nerve palsy, particularly Bell’s palsy, is a common neurological disorder with an annual incidence of 20-30 cases per 100,000 individuals. It is characterized by sudden or gradual facial muscle palsy and is caused by viral reactivation, inflammation, or ischemia of the facial nerve. Prognosis varies widely, depending on the severity of nerve damage and timeliness of the intervention. Steroid therapy remains the cornerstone of Bell’s palsy treatment because it reduces inflammation and facilitates recovery. Early administration, preferably within 72 hours of symptom onset, considerably improves outcomes. However, the efficacy of combination therapy remains controversial. Current guidelines recommend oral steroids as the primary treatment for Bell’s palsy and suggest the selective use of antiviral agents in severe cases or when viral involvement is strongly suspected. For severe facial palsy, such as Ramsay Hunt syndrome or varicella-zoster virus-induced cases, combination therapy may improve outcomes and reduce sequelae; however, high-quality evidence is limited. Steroid therapy is the main treatment of Bell’s palsy and antiviral therapy can be added in severe cases to improve prognosis. Additional research is required to develop standardized guidelines, concerning the use of antiviral therapies in conjunction with steroids.
Association between Socio-Demographic Characteristics and Birth Preparedness and Complication Readiness (BPCR) Practices among Pregnant Women in the Tamale Metropolis: A Cross-Sectional Quantitative Study
Authors: Balanjima Ibrahim , Iddrisu Iklimah Abubakar , Fuchu Abibatu , Bayong-Dumah Sophia , Issah Ibrahim , Issaka Zuwera , Nyewie Martha , Akubori Diana , Talata Angakumpo Dorithy , Pwamang Dorothy Anukem , Kombat Dahamata , Akpablie Faustina Erica , Mumuni Agnes Wihinua , Maayir Faustina Bezagrebere , Bodua-Mango Bernice , Asabia Abel
Published: January 2025

Introduction: Maternal health remains a significant global public health challenge, with high maternal mortality rates particularly prevalent in low- and middle-income countries such as Ghana. This study aims to assess the association between socio-demographic characteristics and birth preparedness and complication readiness (BPCR) practices among pregnant women in the Tamale Metropolis, Northern Region of Ghana.
Methods: This cross-sectional study involved 382 pregnant women from three hospitals in the Tamale Metropolis, selected using a multistage sampling method. Data were collected via a structured questionnaire. Statistical analysis was performed using SPSS version 26, and the chi-square test was used to determine associations, with a p-value of less than 0.05 considered statistically significant.
Results: The study found that 92.1% of respondents were aware of serious health problems during labor and childbirth, with severe vaginal bleeding (97.7%), convulsions (97.2%), and retained placenta (98.0%) being the most commonly recognized issues. Additionally, 83.8% were aware of postpartum health risks, notably severe vaginal bleeding (99.7%) and high fever (97.8%). Additionally, 83.0% are saving for pregnancy and childbirth expenses, and 83.5% have prepared essential items for a clean delivery. Nearly all (94.8%) opted to deliver in a health institution with a skilled provider, and 84.0% have identified transportation plans. Significant associations were found between BPCR and several socio-demographic factors. Age (p=0.048), marital status (p<0.001), religion (p=0.001), educational status (p=0.043), household monthly income (p<0.001), husband’s occupation (p<0.001), and husband’s educational status (p<0.001) all showed significant associations with BPCR.
Conclusion: The study shows significant progress in birth preparedness and complication readiness (BPCR) practices among pregnant women in the Tamale Metropolis, with most demonstrating good practices and awareness of health risks. Socio-demographic factors, such as age, marital status, education, and household income, significantly influence BPCR practices. Health education, financial readiness, and institutional delivery are crucial for maternal health. However, gaps remain in addressing poor practices and overcoming cultural, logistical, and systemic barriers. Recommendations include intensifying educational campaigns, strengthening healthcare infrastructure, introducing financial support mechanisms, and engaging with traditional birth attendants.
Removal of Medicaid Prior Authorization Requirements and Buprenorphine Treatment for Opioid Use Disorder
Authors: Christine Paul J. , Larochelle Marc R. , Lin Lewei (Allison) , McBride Jonathon , Tipirneni Renuka
Published: October 2023

Importance

Buprenorphine treatment for opioid use disorder (OUD) is associated with decreased morbidity and mortality. Despite its effectiveness, buprenorphine uptake has been limited relative to the burden of OUD. Prior authorization (PA) policies may present a barrier to treatment, though research is limited, particularly in Medicaid populations.

Objective

To assess whether removal of Medicaid PAs for buprenorphine to treat OUD is associated with changes in buprenorphine prescriptions for Medicaid enrollees.

Design, Setting, and Participants

This state-level, serial cross-sectional study used quarterly data from 2015 through the first quarter (January-March) of 2019 to compare buprenorphine prescriptions in states that did and did not remove Medicaid PAs. Analyses were conducted between June 10, 2021, and August 15, 2023. The study included 23 states with active Medicaid PAs for buprenorphine in 2015 that required similar PA policies in fee-for-service and managed care plans and had at least 2 quarters of pre- and postperiod buprenorphine prescribing data.

Exposures

Removal of Medicaid PA for at least 1 formulation of buprenorphine for OUD.

Main Outcomes and Measures

The main outcome was number of quarterly buprenorphine prescriptions per 1000 Medicaid enrollees.

Results

Between 2015 and the first quarter of 2019, 6 states in the sample removed Medicaid PAs for at least 1 formulation of buprenorphine and had at least 2 quarters of pre- and postpolicy change data. Seventeen states maintained buprenorphine PAs throughout the study period. At baseline, relative to states that repealed PAs, states that maintained PAs had lower buprenorphine prescribing per 1000 Medicaid enrollees (median, 6.6 [IQR, 2.6-13.9] vs 24.1 [IQR, 8.7-27.5] prescriptions) and lower Medicaid managed care penetration (median, 38.5% [IQR, 0.0%-74.1%] vs 79.5% [IQR, 78.1%-83.5%] of enrollees) but similar opioid overdose rates and X-waivered buprenorphine clinicians per 100 000 population. In fully adjusted difference-in-differences models, removal of Medicaid PAs for buprenorphine was not associated with buprenorphine prescribing (1.4% decrease; 95% CI, −31.2% to 41.4%). For states with below-median baseline buprenorphine prescribing, PA removal was associated with increased buprenorphine prescriptions per 1000 Medicaid enrollees (40.1%; 95% CI, 0.6% to 95.1%), while states with above-median prescribing showed no change (−20.7%; 95% CI, −41.0% to 6.6%).

Conclusions and Relevance

In this serial cross-sectional study of Medicaid PA policies for buprenorphine for OUD, removal of PAs was not associated with overall changes in buprenorphine prescribing among Medicaid enrollees. Given the ongoing burden of opioid overdoses, continued multipronged efforts are needed to remove barriers to buprenorphine care and increase availability of this lifesaving treatment.
Specialty Palliative Care and Symptom Severity and Control in Adolescents and Young Adults With Cancer
Authors: Gupta Sumit , Li Qing , Kassam Alisha , Rapoport Adam , Widger Kimberley , Chalifour Karine , Baxter Nancy N. , Nathan Paul C. , Coburn Natalie G. , Sutradhar Rinku
Published: October 2023

Importance

Adolescents and young adults (AYAs) with cancer experience substantial symptom burden. Specialty palliative care (SPC) is recommended but often not involved or involved late.

Objectives

To determine whether patient-reported symptom severity was associated with subsequent SPC involvement and whether SPC was associated with symptom improvement in AYAs with cancer.

Design, Setting, and Participants

This cohort study comprised AYAs (aged 15-29 years) with primary cancer diagnosed between January 1, 2010, and June 30, 2018, in Ontario, Canada. Data, including self-reported Edmonton Symptom Assessment System (ESAS) scores, were obtained from health care databases. Specialty palliative care was identified through billing codes and validated algorithms. Final data analysis was performed on April 4, 2023.

Main Outcomes and Measures

Associations of ESAS scores with subsequent SPC involvement were determined. A difference-in-differences approach was used for patients who died within 5 years of their cancer diagnosis. Case patients (SPC predeath, index date equals first SPC service) were matched 1:1 to control patients (no SPC at equivalent time before death). The study examined whether the difference between 90-day postindex and preindex mean ESAS scores was itself different between case and control patients.

Results

This study included 5435 AYAs with cancer, with a median follow-up of 5.1 (IQR, 2.5-7.9) years for analyses of general palliative care. Their median age at cancer diagnosis was 25 (IQR, 22-27) years, and more than half were male (2809 [51.7%]). For all symptoms, moderate and severe ESAS scores were associated with an increased likelihood of SPC involvement compared with mild scores. The greatest magnitude of association was seen for pain scores (hazard ratio for severe vs mild, 7.7 [95% CI, 5.8-10.2]; P < .001). A total of 721 AYAs (13.3%) died within 5 years of diagnosis, and 612 of these patients (84.9%) had received SPC before death. Among 202 case-control pairs, SPC involvement was associated with improved pain trajectories (mean scores improved from 3.41 to 3.07 in case patients and worsened from 1.86 to 2.16 in control patients; P = .003). Other symptom trajectories were not affected.

Conclusions and Relevance

In this cohort study of AYAs with cancer, those reporting moderate or severe symptoms through a screening program were more likely to subsequently receive SPC. These findings suggest that SPC was associated with a subsequent decrease in pain severity but did not affect other symptoms. New interventions targeting other symptoms during treatment and particularly at the end of life are needed.