bluuebunny/crossref_metadata_2025_split huggingface dataset:
Numerical Investigation of Equivalence Ratio Effects on a Converted Diesel Engine Using Natural Gas
Authors: Aktas Fatih 
Published: April 2022

Abstract
In this study, a diesel tractor engine is numerically modeled to run entirely on natural gas by installing a natural gas fuel injector on the intake manifold and assembling a spark plug in lieu of a diesel injector. In the numerical study, the methane chemical kinetic mechanism representing natural gas, Reynolds-averaged Navier–Stokes (RANS) k–e turbulence, and the G-equation combustion model were used. The spark-ignition time was assumed to be 719.5 crank angle degree (CAD), which was the start of the diesel injection time. Analysis was carried out at 2300 revolutions per minute (rpm), at a high compression ratio of 17.5:1, at a fixed spark-ignition time, and at eight different equivalence ratios under full load. The equivalence ratio was changed by keeping the air mass constant and reducing the mass of the fuel. The effects of the obtained equivalence ratio on engine performance, combustion characteristics, and emission values were investigated. The results revealed that natural gas could be used up to Φ = 0.60 without affecting performance, increasing emissions, or exceeding the knock limit compared with the diesel cycle. In addition, it was observed that ultralow (below 10 particulate per million (ppm)) emission values could be obtained by further reducing the equivalence ratio, providing a uniform thermal field.
Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO): a pragmatic cluster randomised controlled trial evaluating the effectiveness of a facilitation intervention on recognition and response to clinical deterioration
Authors: Bucknall Tracey K , Considine Julie , Harvey Gillian , Graham Ian D , Rycroft-Malone Jo , Mitchell Imogen , Saultry Bridey , Watts Jennifer J , Mohebbi Mohammadreza , Bohingamu Mudiyanselage Shalika , Lotfaliany Mojtaba , Hutchinson Alison 
Published: April 2022

BackgroundMost hospitals use physiological signs to trigger an urgent clinical review. We investigated whether facilitation could improve nurses’ vital sign measurement, interpretation, treatment and escalation of care for deteriorating patients.MethodsIn a pragmatic cluster randomised controlled trial, we randomised 36 inpatient wards at four acute hospitals to receive standard clinical practice guideline (CPG) dissemination to ward staff (n=18) or facilitated implementation for 6 months following standard dissemination (n=18). Expert, hospital and ward facilitators tailored facilitation techniques to promote nurses’ CPG adherence. Patient records were audited pre-intervention, 6 and 12 months post-intervention on randomly selected days. Escalation of care as per hospital policy was the primary outcome at 6 and 12 months after implementation. Patients, nurses and assessors were blinded to group assignment. Analysis was by intention-to-treat.ResultsFrom 10 383 audits, improved escalation as per hospital policy was evident in the intervention group at 6 months (OR 1.47, 95% CI (1.06 to 2.04)) with a complete set of vital sign measurements sustained at 12 months (OR 1.22, 95% CI (1.02 to 1.47)). There were no significant differences in escalation of care as per hospital policy between study groups at 6 or 12 months post-intervention. After adjusting for patient and hospital characteristics, a significant change from T0 in mean length of stay between groups at 12 months favoured the intervention group (−2.18 days, 95% CI (−3.53 to –0.82)).ConclusionMulti-level facilitation significantly improved escalation as per hospital policy at 6 months in the intervention group that was not sustained at 12 months. The intervention group had increased vital sign measurement by nurses, as well as shorter lengths of stay for patients at 12 months. Further research is required to understand the dose of facilitation required to impact clinical practice behaviours and patient outcomes.Trial registration numberACTRN12616000544471p
Using progression in adapted diabetes complications severity index score to predict erectile dysfunction in men affected by type 2 diabetes mellitus
Authors: Hu Wei Syun , Lin Cheng Li 
Published: April 2022

AbstractObjectiveThis study is on the use of the adapted Diabetes Complications Severity Index (aDCSI) for erectile dysfunction (ED) risk stratification in male patients with type 2 diabetes mellitus (DM).MethodsThis is a retrospective study with records obtained from Taiwan’s National Health Insurance Research Database. Adjusted HRs (aHRs) were estimated by multivariate Cox proportional hazards models with 95% confidence intervals (CIs)..ResultsA population of 84 288 eligible male patients with type 2 DM were included. Compared with change in aDCSI score of 0.0–0.5 per year, the aHRs and the corresponding 95% CIs for other changes in aDCSI scores are summarised as follows: 1.10 (0.90 to 1.34) for change in aDCSI score of 0.5–1.0 per year; 4.44 (3.47 to 5.69) for change in aDCSI score of 1.0–2.0 per year; and 10.9 (7.47 to 15.9) for change in aDCSI score of &gt;2.0 per year..ConclusionsProgression in aDCSI score might be used for ED risk stratification in men affected by type 2 DM.
DISTAL HUMERUS FRACTURES MANAGED WITH OPEN REDUCTION AND INTERNAL FIXATION OR TOTAL ELBOW ARTHROPLASTY RESULT IN SIMILAR RANGE OF MOTION AND REOPERATION RATES
Authors: Gordon Amber , Patel Shaan , Achors Kyle , Horowitz Evan , Smith Carson , Nydick Jason 
Published: April 2022

Introduction: The purpose of our study was to evaluate complications in intraarticular distal humerus fractures in patients above 50 years of age treated with either total elbow arthroplasty (TEA) or open reduction and internal fixation (ORIF). Methods: Between 1999 and 2018, 54 patients, underwent either TEA (27 patients) or ORIF (27 patients) for a distal humerus fracture at a Level 1 trauma center. Pre-operative variables, including mechanism of injury, open or closed fracture, AO/OTA fracture classification, and nerve palsy, were recorded. Main outcomes measurements included postoperative complications and reoperation. Results: Average follow up was 3.3 years for the TEA group and 1.0 year for the ORIF group. The TEA group had 28 complications in 23 total patients Fourteen complications were minor and did not require reoperations. Twelve patients had a major complication requiring reoperation. The ORIF group had 25 complications in 17 patients. Twelve complications were minor and did not require operation. Twelve patients sustained a major complication requiring reoperation. Conclusion: Patients above 50 years of age with intraarticular distal humerus fractures managed with TEA or ORIF have similar reoperation and complication rates.
Schwannoma Arising from the Deep Motor Branch of the Ulnar Nerve – A Case Report and Review of Literature
Authors: GIUNTA Gabriele , DE BAERDEMAEKER Randy , ZELTZER Assaf A. , HAMDI Moustapha 
Published: April 2022

Schwannomas of the ulnar nerve in the hand are uncommon and those arising from the deep motor branch of the ulnar nerve (DMBUN) are rare. We were able to find only five reports of a schwannoma of the DMBUN. We report a schwannoma arising from DMBUN beyond the Guyon canal and summarise the literature on schwannomas involving the DMBUN. Level of Evidence: Level V (Therapeutic)
Contactless Remote 3D Splinting during COVID-19: Report of Two Patients
Authors: SEDIGH Ashkan , KACHOOEI Amir R. , VACCARO Alexander R. , RIVLIN Michael 
Published: April 2022

We used calibrated 2D images uploaded by patients to an online platform to generate a 3D digital model of the limb. This was used to 3D print a splint. This method of 3D printing of splints was used for two patients who were not able to visit the hospital in person due to restrictions placed by the COVID-19 pandemic. Both patients were satisfied with the splint. We feel that this technology could be used to offer additional options to conventional splinting that allows contactless splint fitting. Level of Evidence: Level V (Therapeutic)
Fracture of the Distal Radius by Tuberculous Osteomyelitis: A Case Report and Review of Literature
Authors: GARCIA-REZA Alejandro , CASTRO-MENENDEZ Manuel , DOMINGUEZ-PRADO Diego , YAÑEZ-CALVO Javier 
Published: April 2022

We report a 94-year-old patient with a fractured radius that was being managed conservatively. At 2 months, an abscess was observed overlying the fracture site. An MRI scan was done and samples obtained for microbiological and pathological analyses. The patient was diagnosed with tuberculous osteomyelitis. Surgical debridement of the fracture site was performed, and the bone defect was filled with bone cement impregnated with gentamicin and rifampicin. Anti-tuberculosis therapy was administered for 9 months and the patient made an uneventful recovery. Early diagnosis and correct medical treatment depend on sound evidence of tuberculous osteomyelitis. Surgical debridement is essential if abscesses are present in the bone. Level of Evidence: Level V (Therapeutic)
A Scoping Review of Assistance and Therapy with Head-Mounted Displays for People Who Are Visually Impaired
Authors: Li Yifan , Kim Kangsoo , Erickson Austin , Norouzi Nahal , Jules Jonathan , Bruder Gerd , Welch Gregory F. 
Published: April 2022

Given the inherent visual affordances of Head-Mounted Displays (HMDs) used for Virtual and Augmented Reality (VR/AR), they have been actively used over many years as assistive and therapeutic devices for the people who are visually impaired. In this article, we report on a scoping review of literature describing the use of HMDs in these areas. Our high-level objectives included detailed reviews and quantitative analyses of the literature, and the development of insights related to emerging trends and future research directions.
Our review began with a pool of 1,251 articles collected through a variety of mechanisms. Through a structured screening process, we identified 61 English research articles employing HMDs to enhance the visual sense of people with visual impairments for more detailed analyses. Our analyses reveal that there is an increasing amount of HMD-based research on visual assistance and therapy, and there are trends in the approaches associated with the research objectives. For example, AR is most often used for visual assistive purposes, whereas VR is used for therapeutic purposes. We report on eight existing survey articles, and present detailed analyses of the 61 research articles, looking at the mitigation objectives of the researchers (assistive versus therapeutic), the approaches used, the types of HMDs, the targeted visual conditions, and the inclusion of user studies. In addition to our detailed reviews and analyses of the various characteristics, we present observations related to apparent emerging trends and future research directions.
Insights into Immune Escape During Tumor Evolution and Response to Immunotherapy Using a Rat Model of Breast Cancer
Authors: Gil Del Alcazar Carlos R. , Trinh Anne , Alečković Maša , Rojas Jimenez Ernesto , Harper Nicholas W. , Oliphant Michael U.J. , Xie Shanshan , Krop Ethan D. , Lulseged Bethlehem , Murphy Katherine C. , Keenan Tanya E. , Van Allen Eliezer M. , Tolaney Sara M. , Freeman Gordon J. , Dillon Deborah A. , Muthuswamy Senthil K. , Polyak Kornelia 
Published: April 2022

Abstract

Animal models are critical for the preclinical validation of cancer immunotherapies. Unfortunately, mouse breast cancer models do not faithfully reproduce the molecular subtypes and immune environment of the human disease. In particular, there are no good murine models of estrogen receptor–positive (ER+) breast cancer, the predominant subtype in patients. Here, we show that Nitroso-N-methylurea–induced mammary tumors in outbred Sprague-Dawley rats recapitulate the heterogeneity for mutational profiles, ER expression, and immune evasive mechanisms observed in human breast cancer. We demonstrate the utility of this model for preclinical studies by dissecting mechanisms of response to immunotherapy using combination TGFBR inhibition and PD-L1 blockade. Short-term treatment of early-stage tumors induced durable responses. Gene expression profiling and spatial mapping classified tumors as inflammatory and noninflammatory, and identified IFNγ, T-cell receptor (TCR), and B-cell receptor (BCR) signaling, CD74/MHC II, and epithelium-interacting CD8+ T cells as markers of response, whereas the complement system, M2 macrophage phenotype, and translation in mitochondria were associated with resistance. We found that the expression of CD74 correlated with leukocyte fraction and TCR diversity in human breast cancer. We identified a subset of rat ER+ tumors marked by expression of antigen-processing genes that had an active immune environment and responded to treatment. A gene signature characteristic of these tumors predicted disease-free survival in patients with ER+ Luminal A breast cancer and overall survival in patients with metastatic breast cancer receiving anti–PD-L1 therapy. We demonstrate the usefulness of this preclinical model for immunotherapy and suggest examination to expand immunotherapy to a subset of patients with ER+ disease.
See related Spotlight by Roussos Torres, p. 672
Arboreal wildlife bridges in the tropical rainforest of Costa Rica’s Osa Peninsula
Authors: Flatt Eleanor , Basto Arianna , Pinto Carolina , Ortiz Johan , Navarro Kassandra , Reed Neil , Brumberg Hilary , Chaverri Marco Hidalgo , Whitworth Andrew 
Published: April 2022

Abstract
Linear infrastructures, especially roads, affect the integrity of natural habitats worldwide. Roads act as a barrier to animal movement, cause mortality, decrease gene flow and increase the probability of local extinctions, particularly for arboreal species. Arboreal wildlife bridges increase connectivity of fragmented forests by allowing wildlife to safely traverse roads. However, the majority of studies about such infrastructure are from Australia, while information on lowland tropical rainforest systems in Meso and South America remains sparse. To better facilitate potential movement between forest areas for the arboreal wildlife community of Costa Rica’s Osa Peninsula, we installed and monitored the early use of 12 arboreal wildlife bridges of three different designs (single rope, double rope, and ladder bridges). We show that during the first 6 months of monitoring via camera traps, 7 of the 12 bridges were used, and all bridge designs experienced wildlife activity (mammals crossing and birds perching). A total of 5 mammal species crossing and 3 bird species perching were observed. In addition to preliminary results of wildlife usage, we also provide technical information on the bridge site selection process, bridge construction steps, installation time, and overall associated costs of each design. Finally, we highlight aspects to be tested in the future, including additional bridge designs, monitoring approaches, and the use of wildlife attractants.
“And My Sin Is Ever Before Me” (Psalm 51: 3)
Authors: Unger Daniel M. 
Published: April 2022

AbstractThe article highlights the added value with which the scene of David with the head of Goliath has accumulated in the seventeenth century. During this period these paintings were intended to represent the young David as a penitent saint atoning for his sins rather than the divinely supported triumph of the young shepherd over Goliath, the skilled and talented military hero. What is emphasized is the a-temporal nature of this iconography, using David, the boy who killed Goliath as atoning for his most grievous sin that he committed many years later when he was already king of Israel toward Uriah the Hittite. In what follows I would like to characterize the unique iconography developed in the early seventeenth century, which represents the young David as a penitent while Goliath’s head signals thememento mori. Goliath’s severed head stands for the skulls appearing in other visual representations of penitent saints.
Incarnating Image
Authors: Malton Sara 
Published: April 2022

Abstract
This essay examines the significance of Frederic Leighton’s illustrations of George Eliot’s historical novel of Renaissance Florence, Romola (1862–1863). Leighton’s illustrations form a crucial part of Eliot’s vision of her heroine’s movement toward spiritual liberation. Eliot and Leighton together figure this evolution as a pilgrimage that takes us from the Old Testament to the Gospel of John, concluding with one of the most significant moments in the life of Christ: his encounter with the Woman at the Well. Leighton’s depictions of the heroine and Eliot’s narrative powerfully combine to show how Romola’s connection to sacrificial love is combined with increasing authority, as she becomes imagined as the force who unites both the prophetic Old Testament with the manifestations of the New. Romola thus uniquely underscores the place of a complex Victorian aesthetic and print culture within a genealogy of cultural renderings of female agency and mobility.
The Holy Book Which Is a Book
Authors: Gibson Richard Hughes 
Published: April 2022

Abstract
For more than two centuries, publishers and critics have tried to design an English Bible that would be easy to hold and a delight to read. This essay tracks various attempts to design such a bible, beginning with early nineteenth-century printings that sought to declutter the bible page and to break the thick book into multiple volumes, before turning to early calls to revise the Authorized Version (a.k.a. the King James Version) so that it would be easier for modern audiences to comprehend. The latter half of the essay examines two recent efforts to reform the English Bible physically and textually, Adam Lewis Greene’s Bibliotheca (2016) and Robert Alter’s The Hebrew Bible: A Translation with Commentary (2018), arguing that each makes important strides toward producing the long-awaited “readable Bible.”
Fisheries Subsidies and the World Trade Organization: A Concise History
Authors: Reinert Kenneth A. 
Published: April 2022

Abstract
Fisheries play a critical role in global food security. Unfortunately, marine fish resources are significantly depleted, and widespread use of fisheries subsidies contribute to this depletion. Multilateral negotiations on fisheries subsidies began at the World Trade Organization in 2001 as part of the Doha Round. They have continued to this day with recent renewed emphasis. A successful wto agreement on fisheries subsidies will be necessary for sustainable fisheries, food security, and the continued relevance of the wto. Unfortunately, despite years of negotiations and a stable draft text, an agreement remains somewhat elusive.
Ethnic Federalism and Minority in Ethiopia
Authors: Kasse Getaye Mulugeta 
Published: April 2022

Abstract
Though the normative and empirical theory of designing a Territorial Autonomy to give a response to the demand of ethno-cultural groups is dominant, equivocally, it is problematic in addressing the needs of dispersed minorities. To this end, the Nonterritorial Autonomy political theory has acquired a significant level of attention in the last two decades as a promising response for intra-unit minorities, and the model can coexist with Territorial Autonomy. By examining the current Territorial Autonomy in the form of Ethnic federalism in Ethiopia, this article highlighted the conventional understanding of autonomy and territoriality for not being suitable for dispersed minorities inhabited in the regional states. Thus, alternative arrangements that can complement Territorial autonomy must be examined. The article defends the Nonterritorial Autonomy model as a novel solution to the complications faced by dispersed minorities in Ethiopia; concomitantly, it is complementary to Territorial Autonomy.
The Rohingya Crisis in Myanmar
Authors: Debnath Kunal , Chatterjee Souvik , Afzal Afnan Bint 
Published: April 2022

Abstract
The Rohingyas, one of the most vulnerable refugee groups in the world, have suffered from continuous state sponsored terrorism by the Burmese government since Myanmar’s independence in 1948. Religion and ethnic differences are often contemplated as the major reason for the Rohingya crisis. However, this paper argues instead of only focusing upon ethno-religious dimension of the Rohingya conflict, the geo-strategic and resource centric explanation also need to be addressed. For the above-mentioned purpose, this research analyses how the Rohingya crisis is robustly linked with geo-strategic factors and politics of natural resources. In this context, the role and activities of the Government of Myanmar and military force in the Rakhine province are explained. In addition, this paper also examines the geo-economic interests of some foreign forces in Rakhine state. Based on qualitative analysis, data are collected from both primary and secondary sources such as books, journal articles, reports of government, etc. The research shows that the Rohingya’s persecution, displacement have a possible connection with the resources and geo-strategic factors that are present in the Rakhine state. This study further implies, the resources and geo-strategic factors also influence the Myanmar’s policies and actions and the engagement of military forces in the Rohingya crisis. Therefore, this new geo-strategic and resource centric explanation which are often overlooked can provide a better understanding of the Rohingya crisis.
The Agencies of the ‘Co-Opted’
Authors: Peeters Goloviznina Marina 
Published: April 2022

Abstract
The article untangles the relationship between Indigenous Peoples organisations (ipo s) and the Russian government in domestic and international political forums over the 1990s-2020s. It links two debates on co-optation and Indigenous peoples’ rights norms contestation, offering a more nuanced view of them as complex, incremental, and dynamic processes in the Russian authoritarian regime. By proceeding from the bifurcation of the contemporary ipo sector, the analysis identifies and examines two groups of ipo s – ‘operational’ and ‘advocacy.’ The article argues that each group of ipo s still preserves some limited capacity to contest the state normative behaviour in the given political environment, yet differently. While ‘operational’ ipo s opt for discursive contestation through appropriation, the ‘advocacy’ ipo s express their dissent by acting as nomads. Both tactics enable each group to create opportunities to effect some progressive, albeit modest, policy and legislative changes.
This Mass Atrocity was Brought to You by the Ivory Trade: Linking Transnational Organized and International Crimes
Authors: Kersten Mark 
Published: April 2022

Abstract
Scant attention has been paid to the relationship between the perpetration of transnational organized crimes (toc s) and international crimes. This paper endeavours to instigate increased scrutiny of how these two crime sets interact. Relying on contributions from conflict and peace studies, I argue that it is useful to study their interaction within an international-transnational crime complex. To elaborate, I explore four conflicts in which an international-transnational crime complex is evident: Kosovo, Sierra Leone, northern Uganda, and Syria. Taken together, these cases demonstrate that these crimes types are linked irrespective of geographic location or the type of actors involved. The paper subsequently explores legal responses available to actors, including the International Criminal Court and specialized domestic units, which could link the prosecution and prevention of toc s and international crimes. The paper concludes with some reflections on the need to further interrogate—in both legal practice and scholarly work—international-transnational crime complexes.