bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability and clinical validity of the Kang MRI grading system for cervical central spinal stenosis
Authors: Fahmy Yara , Hafez Abeer Abd El Maksoud , Shehata Khaled Ahmed Ali , Diasty Shaimaa El Metwally El 
Published: November 2023

Abstract
Background
The Kang MRI grading system for central cervical spinal stenosis has been previously explored in literature. The aim of the current study was to re-visit the system before adopting it into our institute’s cervical spine MRI reports and to evaluate its reliability through measuring the degree of agreement between radiologists of different levels of experience. The secondary aim was to evaluate its clinical validity by correlating between the radiological grade and the clinical symptoms as well as the subsequent treatment received by the patients.

Results
A total of 82 patients (21 males and 61 females, mean age = 42.8 years) that underwent cervical spine MRI in our institute were included in the study. Two specialized musculoskeletal radiologists and two radiology residents at different levels of experience independently graded the central cervical spinal stenosis at the narrowest level using the Kang grading system. Substantial agreement was found between all the participating radiologists (K = 0.665–0.799, percentage of agreement = 78.04–86.58%). Correlation between radiological grade and the presence of neuropathic symptoms (upper extremity paresthesias and/or numbness), motor affection (upper extremity weakness and/or weak hand grip), and treatment received by the patients was moderate, with R ranging from 0.325–0.440, 0.420–0.506, and 0.452–0.592 respectively. Correlation between grade and the presence of cervical pain was weak, with R = 0.197–0.253. On subdividing the grade 2 patients into grade 2a (demonstrable spinal cord deformity at the anterior or posterior aspects of the cord only) and grade 2b (demonstrable spinal cord deformity at both the anterior and posterior aspects of the cord), a statistically significant difference was found regarding the prevalence of motor affection among the patients in both sub-groups (P < 0.001).

Conclusion
Despite being reliable and clinically valid, the Kang grading system needs revision of the use of sagittal T2 images only as well as the definition of grade 2. We showed that the current definition of grade 2 to be rather broad, putting a wide array of patients into a single category. Sub-dividing it might increase the accuracy of the grading system.
An exposure-based implementation strategy to decrease clinician anxiety about implementing suicide prevention evidence-based practices: protocol for development and pilot testing (Project CALMER)
Authors: Becker-Haimes Emily M. , Brady Megan , Jamison Jesslyn , Jager-Hyman Shari , Reilly Megan E. , Patel Esha , Brown Gregory K. , Mandell David S. , Oquendo Maria A. 
Published: November 2023

Abstract
Background
Clinicians often report that their own anxiety and low self-efficacy inhibit their use of evidence-based suicide prevention practices, including gold-standard screening and brief interventions. Exposure therapy to reduce clinician maladaptive anxiety and bolster self-efficacy use is a compelling but untested approach to improving the implementation of suicide prevention evidence-based practices (EBPs). This project brings together an interdisciplinary team to leverage decades of research on behavior change from exposure theory to design and pilot test an exposure-based implementation strategy (EBIS) to target clinician anxiety to improve suicide prevention EBP implementation.

Methods
We will develop, iteratively refine, and pilot test an EBIS paired with implementation as usual (IAU; didactic training and consultation) in preparation for a larger study of the effect of this strategy on reducing clinician anxiety, improving self-efficacy, and increasing use of the Columbia Suicide Severity Rating Scale and the Safety Planning Intervention in outpatient mental health settings. Aim 1 of this study is to use participatory design methods to develop and refine the EBIS in collaboration with a stakeholder advisory board. Aim 2 is to iteratively refine the EBIS with up to 15 clinicians in a pilot field test using rapid cycle prototyping. Aim 3 is to test the refined EBIS in a pilot implementation trial. Forty community mental health clinicians will be randomized 1:1 to receive either IAU or IAU + EBIS for 12 weeks. Our primary outcomes are EBIS acceptability and feasibility, measured through questionnaires, interviews, and recruitment and retention statistics. Secondary outcomes are the engagement of target implementation mechanisms (clinician anxiety and self-efficacy related to implementation) and preliminary effectiveness of EBIS on implementation outcomes (adoption and fidelity) assessed via mixed methods (questionnaires, chart-stimulated recall, observer-coded role plays, and interviews).

Discussion
Outcomes from this study will yield insight into the feasibility and utility of directly targeting clinician anxiety and self-efficacy as mechanistic processes informing the implementation of suicide prevention EBPs. Results will inform a fully powered hybrid effectiveness-implementation trial to test EBIS’ effect on implementation and patient outcomes.

Trial registration
Clinical Trials Registration Number: NCT05172609. Registered on 12/29/2021.
Strategic palmar trimming before conventional shoeing shows potential for managing underrun heels in horses
Authors: Poochipakorn Chanoknun , Sanigavatee Kanokpan , Wonghanchao Thita , Huangsaksri Onjira , Chanda Metha 
Published: November 2023

Background: This study aimed to investigate the potential of strategic palmar trimming before conventional shoeing for managing hoof malconformation in horses with underrun heels. Methods: Eleven affected horses were divided into control (5 horses with 14 defective hooves) and experimental (6 horses with 16 defective hooves) groups. The experimental group underwent strategic palmar trimming before conventional shoeing, while the control horses received regular trimming before traditional shoeing. Dorsal hoof wall angle (DHWA)/heel angle (HA) ratios, heel-bulb distance, and six parallel lines indicating solar surface dimension were determined before, and after 5, 10, 15, 20, 25, and 30 weeks of the different farriery protocols. Palmar trimming distance was only measured in experimental horses. Results: A group-by-time interaction was observed for DHWA/HA ratios and solar surface dimension. Separate effects for group and time were observed in the heel–bulb distance. A modification in hoof conformation was detected at 25-30 weeks only in horses in the experimental group, including decreases in DHWA/HA ratio, heel–bulb distance, and palmar trimming distance, coinciding with an increase in palmar width of trimmed hooves. Conclusions: Different trimming protocols produced a different effect on hoof conformation. Therefore, tactical remedial trimming can potentially control poor hoof conformation in horses with underrun heels.
Understanding the Impacts of COVID Policy Changes on Access to Needed Supports for Families With Children Receiving Medicaid HCBS Waiver Services
Authors: Shogren Karrie A. , Dean Evan E. , Chapman Richard , Swindler Sean , Smith Heather , Bigler Kayzy 
Published: November 2023

Abstract
The COVID-19 pandemic necessitated rapid policy changes to address new demands on disability service systems. A statewide survey of families of people who received Medicaid funded home- and community-based (HCBS) long-term services and supports (LTSS) in one Midwestern state was conducted to understand (1) utilization of services allowed under the policy change, (2) family’s experiences if their family member with a disability accessed the services, and (3) family’s perspectives on the need for ongoing changes in the future. Overall, the results suggest that a subset of families took advantage of flexibilities introduced into service delivery models during the pandemic, and the changes—when accessed—addressed important needs that a large majority of families that accessed the services hoped would be sustained in the future.
Return on investments in the Health Extension Program in Ethiopia
Authors: Bowser Diana , Kleinau Eckhard , Berchtold Grace , Kapaon David , Kasa Leulsegged 
Published: November 2023

Background
Since 2003, the government of Ethiopia has trained and deployed more than 42,000 Health Extension Workers across the country to provide primary healthcare services. However, no research has assessed the return on investments into human resources for health in this setting. This study aims to fill this gap by analyzing the return on investment within the context of the Ethiopian Health Extension Program.

Methods
We collected data on associated costs and benefits attributed to the Health Extension Program from primary and secondary sources. Primary sources included patient exit interviews, surveys with Health Extension Workers and other health professionals, key informant interviews, and focus groups conducted in the following regions: Amhara, Oromia, Tigray, and the Southern Nations Nationalities and Peoples’ Region. Secondary sources consisted of financial and administrative reports gathered from the Ministry of Health and its subsidiaries, as well as data accessed through the Lives Saved Tool. A long-run return on investment analysis was conducted considering program costs (personnel, recurrent, and capital investments) in comparison to benefits gained through improved productivity, equity, empowerment, and employment.

Findings
Between 2008–2017, Health Extension Workers saved 50,700 maternal and child lives. Much of the benefits were accrued by low income, less educated, and rural women who had limited access to services at higher level health centers and hospitals. Regional return ranged from $1.27 to $6.64, with an overall return on investment in the range of $1.59 to $3.71.

Conclusion
While evidence of return on investments are limited, results from the Health Extension Program in Ethiopia show promise for similar large, sustainable system redesigns. However, this evidence needs to be contextualized and adapted in different settings to inform policy and practice. The Ethiopian Health Extension Program can serve as a model for other nations of a large-scale human resources for health program containing strong economic benefits and long-term sustainability through successful government integration.
Article 29a – Towards a new Strategic Dimension in Supervisory Convergence?
Authors: Skovmand Rasmussen Niels , Dietz Legind Nina 
Published: November 2023

Abstract

409As part of the 2019 reform of the European System of Financial Supervision, the three European Supervisory Authorities were granted a completely new convergence tool in Article 29a to promote a common supervisory culture. This tool allows them to identify up to two Union Strategic Supervisory Priorities that the National Competent Authorities shall take into account when drawing up their work programme. The article provides a doctrinal legal analysis of each procedural step in Article 29a; from information gathering to assessment of national work programmes and follow-up measures. On this basis, it is argued that Article 29a has expanded the scope of the ESAs’ existing toolkit; from the operational to the strategic level. Hereby the USSPs have essentially brought a new strategic orientation to the former level 3 of the Lamfalussy process. However, this institutional development also raises several key challenges related to the ESA/NCA relationship that call for attention in the further development of this convergence tool.410
Transrectal osteopathic manipulation treatment for chronic coccydynia: feasibility, acceptability and patient-oriented outcomes in a quality improvement project
Authors: Nourani Bobby , Norton Derek , Kuchera William , Rabago David 
Published: November 2023

Abstract

Context
Pain of the coccyx, coccydynia, is a common condition with a substantial impact on the quality of life. Although most cases resolve with conservative care, 10 % become chronic and are more debilitating. Treatment for chronic coccydynia is limited; surgery is not definitive. Osteopathic manipulative treatment (OMT) is the application of manually guided forces to areas of somatic dysfunction to improve physiologic function and support homeostasis including for coccydynia, but its use as a transrectal procedure for coccydynia in a primary care clinic setting is not well documented.

Objectives
We aimed to conduct a quality improvement (QI) study to explore the feasibility, acceptability, and clinical effects of transrectal OMT for chronic coccydynia in a primary care setting.

Methods
This QI project prospectively treated and assessed 16 patients with chronic coccydynia in a primary care outpatient clinic. The intervention was transrectal OMT as typically practiced in our clinic, and included myofascial release and balanced ligamentous tension in combination with active patient movement of the head and neck. The outcome measures included: acceptance, as assessed by the response rate (yes/no) to utilize OMT for coccydynia; acceptability, as assessed by satisfaction with treatment; and coccygeal pain, as assessed by self-report on a 0–10 numerical rating scale (NRS) for coccydynia while lying down, seated, standing, and walking.

Results
Sixteen consecutive patients with coccydynia were offered and accepted OMT; six patients also received other procedural care. Ten patients (two males, eight females) received only OMT intervention for their coccydynia and were included in the per-protocol analysis. Posttreatment scores immediately after one procedure (acute model) and in follow-up were significantly improved compared with pretreatment scores. Follow-up pain scores provided by five of the 10 patients demonstrated significant improvement. The study supports transrectal OMT as a feasible and acceptable treatment option for coccydynia. Patients were satisfied with the procedure and reported improvement. There were no side effects or adverse events.

Conclusions
These data suggest that the use of transrectal OMT for chronic coccydynia is feasible and acceptable; self-reported improvement suggests utility in this clinic setting. Further evaluation in controlled studies is warranted.
Praxis, Diagramm, Körper. Die epistemologischen

turns und die Rehabilitation von Kants Euklidizitätsthese
Authors: Beck Martin 
Published: November 2023

Abstract
This paper aims to show how Kant’s concept of mathematical intuition and his thesis of the Euclidicity of space have been rehabilitated by recent interpretations that refer to the concepts of practice, diagrams, and the body. This involves criticising the idea of mathematics as a purely logical and axiomatic science, reading Kant’s theory of geometric intuition as a theory of diagrammatic visualizations, and showing how Kant’s idea of the Euclidicity of space can be justified with reference to embodied experience. These readings contradict the critique of Kant voiced by logicism and logical empiricism. They show that Kant’s notion of non-empirical intuition refers to the embeddedness of human cognition in embodied, media-based practices that function as a third epistemological realm alongside the conceptual and the empirical.
Mechanical and microstructural characterization of resistance spot welded dissimilar TWIP1000/TRIP800 joints
Authors: Özen Fatih 
Published: November 2023

Abstract
In this work, resistance spot weldability of dissimilar TWIP1000/TRIP800 joint was investigated in terms of microstructural and mechanical characterization. The maximum tensile-shear load bearing capacity was 16,918 N in 6 kA welding current with 30 cycles of welding duration. Pull-out failure which was dominant and interfacial failure modes were obtained in tensile-shear tests. Although heat affected zone of the TRIP steel was totally transformed into tempered martensite, it showed better separation performance than TWIP steel. Heat affected zone of the TWIP steel was narrow, secondary phase formations and sudden grain coarsening have compromised the weakest point in the resistance spot welded joint.
Effects of compaction pressure on microstructure, mechanical properties, and machining characteristics of sintered AISI 316L steel
Authors: Erden Mehmet Akif , Köklü Uğur , Güldibi Ahmet Serdar , Elitaş Muhammed 
Published: November 2023

Abstract
In this study, the effect of compaction pressure on the properties of AISI 316L and its machining performance was evaluated. AISI 316L powders were subjected to three different compaction pressures (550, 650, and 750 MPa). Subsequently, the samples were sintered in an argon atmosphere at a constant temperature of 1523.15 K. The microstructure, hardness, and mechanical properties of the materials were investigated. To examine the effect of compaction pressure on drilling characteristics (thrust force, torque, surface roughness, chip formation, and burr formation), the samples were subjected to dry drilling at different feed rates and cutting speeds. It was observed that increasing the compaction pressure resulted in smaller grain sizes in the microstructure, increased hardness, and higher tensile strength. Higher compaction pressure led to higher thrust force and torque, whereas lower compaction pressure resulted in improved hole surface quality and shorter chips. Additionally, at higher cutting speeds, the color of the chips changed due to the elevated temperatures associated with increased cutting speeds.
Dry sliding wear behavior of AA7075 alloy produced by thixocasting
Authors: Bilgen Hudaverdi , Sahin Omer , Akar Neset , Kilicli Volkan 
Published: November 2023

Abstract
In this study, the wear behavior of AA7075 alloy produced by thixocasting was investigated. The wear behavior of the AA7075 alloy is examined for three cases: extruded with T6 heat treatment, as-thixocast, and thixocast with T6 conditions. The dry sliding wear test was conducted with a tribometer according to ASTM G-99 standard. The microstructures were characterized by optical microscopy, scanning electron microscopy (SEM), and energy-dispersive X-ray analysis (EDX). The tensile and hardness tests were performed to evaluate the mechanical properties. The AA7075 alloy was successfully shaped by thixocasting. The as-thixocast sample exhibited typical globular structures with multinary eutectic structures along the grain boundaries. The globular grains transform into a polygonal structure, and the grain size increases from 50 μm to 60 μm in the thixocast + T6 sample. This microstructure exhibited excellent wear resistance under dry sliding conditions in the thixocast + T6 sample. The aging treatment with prolonged solution process improved the mechanical properties two times and the wear rate three times for the thixocast AA7075 alloy. Furthermore, the thixocast + T6 sample exhibited a significant decrease in the coefficient of friction with the lowest wear rate compared to the as-thixocast sample. The dominant wear mechanisms are microdelamination, adhesion, and oxidation in all samples.
Developmental outcomes with perinatal exposure (DOPE) to prescription opioids
Authors: Flores Adrian , Nguyen Nghi M. , Pendyala Gurudutt 
Published: November 2023

AbstractResearchers have found considerable evidence in the past 20 years that perinatal opioid exposure leads to an increased risk of developmental disorders in offspring that persist into adulthood. The use of opioids to treat pain concerning pregnancy, delivery, and postpartum complications has been rising. As a result, communities have reported a 300–400 % increase in Neonatal Opioid Withdrawal Syndrome (NOWS). NOWS represents the initial stage of several behavioral, phenotypic, and synaptic deficits. This review article summarizes the Developmental Outcomes of Perinatal Exposure (DOPE) to prescription opioids. Moreover, we also seek to connect these findings to clinical research that describes DOPE at multiple stages of life. Since specific mechanisms that underlie DOPE remain unclear, this article aims to provide a framework for conceptualizing across all ages and highlight the implications they may have for longevity.
Insights into the thermal characteristics and dynamics of stagnant blood conveying titanium oxide, alumina, and silver nanoparticles subject to Lorentz force and internal heating over a curved surface
Authors: Li Shuguang , Li Yijie , Al Mesfer Mohammed K. , Ali Kashif , Jamshed Wasim , Danish Mohd , Irshad Kashif , Ahmad Sohail , Hassan Ahmed M. 
Published: November 2023

Abstract
It is very significant and practical to explore a triple hybrid nanofluid flow across the stuck zone of a stretching/shrinking curved surface with impacts from stuck and Lorentz force factors. The combination (Ag–TiO2–Al2O3/blood) hybrid nanofluid is studied herein as it moves across a stagnation zone of a stretching/shrinking surface that curves under the impact of pressure and Lorentz force. Exact unsolvable nonlinear partial differential equations can be transformed into ordinary differential equations that can be solved numerically by similarity transformation. It was discovered that predominant heat transfers and movement characteristics of quaternary hybrid nanofluids are dramatically affected. Numerous data were collected from this study to illustrate how parameters of flow affect the temperature, velocity, heat transmission, and skin friction characteristics. The axial and radial velocities for both fluids (Newtonian and ternary hybrid nanofluid) are increased due to the increasing function of the curvature parameter, magnetic field, and suction parameter. Additionally, the direct relationship between the temperature and heat transfer decreases the heat transfer rate by the curvature parameter, magnetic field, suction parameter, Prandtl number, and heat source/sink. The higher the values of the curvature parameter, the higher the shear stress and velocity.
Framing the Market: The Unexpected Commonalities between Karl Polanyi and the Ordoliberals
Authors: Dekker Erwin 
Published: November 2023

Abstract
There has been a resurgence in scholarship on Karl Polanyi in recent years, against the backdrop of rising populism and critiques of globalization and financialization. In these works, Polanyi is typically portrayed as critic of the contested notion of ‘neoliberalism’. In this paper I demonstrate that, to the contrary, Polanyi’s Great Transformation (1944) shares many of the themes central to the contributions of the early neoliberals, specifically the ordoliberal thinkers. Polanyi and the ordoliberals did not only seek to analyze the origins of the same social crisis of the 1930 s and 40 s, but their analysis of the deficiencies of nineteenth-century liberalism as well as the subsequent disintegration through rapidly growing interventions in favor of powerful groups in society has much in common. This paper explores these similarities and demonstrates that they also extended to the way they perceived the responsibility of scientists as well as the interdependence of the various orders in society. It is argued that the ordoliberals, their fellow-traveler F. A. Hayek and Karl Polanyi all perceived the interdependence between the state, civil society and the market somewhat differently, but agreed on the need to conceptualize the relationship between the three. Finally, it is suggested that even the normative ideal of Karl Polanyi, the realization of ‘freedom in a complex society’, has important commonalities with the ordoliberal program: the protection of individual freedom from concentrated forms of power in society.