bluuebunny/crossref_metadata_2025_split huggingface dataset:
A flexible upgrade path for the Australian National Broadband Network
Authors: A. Gregory Mark 
Published: September 2019

This paper provides a flexible upgrade path for the Australian National Broadband Network (NBN), if the new government decides to alter the construction methodology to include a copper-based access system such as Fibre to the Node (FTTN). The approach described in this paper utilises fibre past premises to provide a transmission media for a Gigabit-capable Passive Optical Network (GPON). GPON to FTTN devices would be situated in pits adjacent to premises and utilise copper tails to provide a VDSL2 Internet connection to premises. The approach provides a flexible upgrade path for customers to move from their copper based access system to a Fibre to the Home (FTTH) system utilising the relatively future-proof GPON.
EXTENSÃO UNIVERSITÁRIA E O COMBATE À INTOLERÂNCIA RELIGIOSA AS RELIGIÕES DE MATRIZES AFRICANAS
Authors: Luca Taissa Tavernard de , Neto Manoel Vitor Barbosa , Pantoja Juscelio Mauro De Mendonça 
Published: September 2019

O presente trabalho aborda a importância da extensão universitária a partir da experiência do Grupo de Estudos de Religiões de Matriz Africana na Amazônia - GERMAA da Universidade do Estado do Pará como ação de parceria para a efetivação da Lei 10.639/03 e para o combate a intolerância religiosa contra as religiões afro-brasileiras. Para isso, refletimos sobre a intolerância religiosa como ação de etnocentrismo a partir de ROCHA (1988) e geradora de estigma (GOFFMAN 1990), sobre o papel da universidade nos processos educativos escolares à luz de CHAUÍ (2003) e sobre a proposta de ação extensionista a partir de FREIRE (1983). Conclui-se que as atividades de extensão constituem-se em ações necessárias para o processo educativo, independente do nível de ensino.
GIRA DE SANTO E CABOCLO NO “RECANTO DE OGUM” DE PAI KANZILÊ – IMAGENS DE UM TERREIRO NAGÔ DA CIDADE DE SOURE (MARAJÓ/PARÁ)
Authors: Cardoso Wladirson R. da S. 
Published: September 2019

As imagens reunidas neste ensaio constituem o acervo de fotos registradas e utilizadas em tese de doutoramento, intitulada “Para além da juventude – “antropologia da experiência” e do “modo de vida gay” de homossexuais masculinos em processo de envelhecência da cidade de Soure (Marajó/Pará)”, realizada no e defendida pelo Programa de Pós-Graduação em Antropologia da Universidade Federal do Pará (PPGA/UFPA), entre os anos de 2010 e 2014, sob a supervisão e orientação do Prof. Dr. Ernani Pinheiro Chaves...
Ipsilateral Posterior Cruciate Ligament Insertion Avulsion and Femoral Head Fracture Without Dislocation: A Rarest of Rare Dashboard Injury and Principles of Management
Authors: Kumar Prasoon , Agarwal Saurabh , Rajnish Rajesh Kumar , Aggarwal Sameer , Kumar Vishal , Jindal Karan 
Published: September 2019

Case:
A 25-year-old man presented with posterior cruciate ligament (PCL) avulsion and ipsilateral fracture of the femoral head after sustaining a dashboard injury. The hip was not dislocated on presentation, and there were no other injuries; he was managed operatively for both. His hip and knee healed well, with good functioning at 15 months of follow-up.

Conclusions:
Dashboard injuries can cause simultaneous knee and hip injuries, usually PCL and posterior hip dislocation. This case report identifies a specific pattern of tibial avulsion fracture of the PCL combined with femoral head fracture with no dislocation at presentation. The good outcome achieved at 15 months indicates that standard treatment of open reduction and internal fixation for both fractures can provide good clinical results in this severe combination injury pattern.
Distal Femur Insufficiency Fracture in a Pediatric Patient: An Atypical Presentation of Osteogenesis Imperfecta
Authors: Aya Kessiena L. , Carmichael Kelly D. , Igbinigie Matthew 
Published: September 2019

Case:
We present an unusual case of a distal metaphyseal femur insufficiency fracture in an adolescent with a history of multiple low-energy appendicular fractures. A genetic workup was significant for a variant of unknown significance to the Col1A1 gene.

Conclusions:
To our knowledge, this is the first report of this collagen gene variant as a risk factor for multiple fractures. The case illustrates the presentation of this gene’s phenotype and suggested medical management.
Evaluation of an Incorporated Superior Capsular Reconstruction Graft
Authors: Samade Richard , Jones Grant L. , Bishop Julie Y. 
Published: September 2019

Case:A 66-year-old man presented with 2 years of atraumatic right shoulder pain and difficulty with overhead activities. Radiographs and magnetic resonance imaging demonstrated Hamada stage I changes and a massive irreparable rotator cuff tear involving the supraspinatus and infraspinatus. He underwent superior capsular reconstruction with acellular human dermal matrix (SCR with ADM) allograft. Diagnostic arthroscopy and humeral avulsion of the glenohumeral ligament repair 1 year postoperatively showed that the SCR appeared intact and vascularized.Conclusions:This is the first study to confirm visually that SCR with ADM allograft is well-vascularized and intact 1 year post-operatively.
Extraction of a Bent Tibial Nail After Refracture
Authors: McChesney Grant R. , Gurbani Barkha N. , Hagedorn John C. 
Published: September 2019

Case:
A 65-year-old man previously treated by intramedullary nailing for a left tibial shaft fracture presented 6 years later with an open refracture of his left tibia after a motorcycle accident. Treatment required extraction of the bent nail before revision nailing.

Conclusions:
Extraction of deformed intramedullary devices is a skill that will continue to be demanded of orthopaedic surgeons. In this case, standard extraction though the entry point proved successful. Standard extraction offers the safest form of removal and should be contemplated before considering more morbid methods of extraction while examining the fracture's morphology and the device's deformity.
Proposal of a New Type of Innominate Osteotomy without the Use of Bone Graft in Children
Authors: Morita Mitsuaki , Kamegaya Makoto , Takahashi Daisuke , Kamada Hiroshi , Tsukagoshi Yuta , Tomaru Yohei 
Published: September 2019

Background:
Good long-term outcomes have been reported for the Salter innominate osteotomy (SIO), which is widely used to correct developmental dysplasia of the hip (DDH) in children. In this study, we describe the procedure and early outcomes of a new pelvic osteotomy termed “angulated innominate osteotomy” (AIO).

Methods:
Twenty-one patients (22 hips) underwent AIO. We evaluated age at the time of surgery, operative time, blood loss, and time to bone union. Several radiographic parameters were assessed preoperatively, immediately postoperatively, and at the time of the latest examination. Measurements were compared with those of 20 previous patients who underwent SIO. The AIO is made to form an isosceles triangle. This enables 2 points of contact between the proximal and distal bone fragments, eliminating the need for a bone graft.

Results:
Mean age at the time of surgery was 5.9 years, and the mean duration of follow-up was 30.8 months. The mean operative time was 103 minutes, mean blood loss was 33 mL, and mean time to bone union was 9.8 weeks. Immediately postoperatively, the mean “distance d” (lateral displacement of the distal fragment), mean ratio of the obturator heights (ROH), and mean lateral rotation angle (LRA) were 7.2 mm, 70.4%, and 19.3°, respectively. At the latest examination, the mean acetabular index (AI), center-edge angle (CEA), and acetabular head index (AHI) were 16.4°, 23.7°, and 85.5%, respectively, each of which were significantly improved compared with the preoperative values. Moreover, the mean postoperative iliac length difference (ILD) between the operative and contralateral sides was only 0.1 mm. Those treated with AIO had a significantly shorter operative time and time to bone union, and less blood loss, than those treated with SIO. The mean distance d, ROH, and LRA did not differ significantly from SIO results, while the mean ILD was significantly less.

Conclusions:
AIO is a less-invasive procedure that does not require a bone graft, and the short-term outcomes were favorable. Sufficient coverage of the acetabulum with displacement of the distal bone fragment to an extent similar to SIO can be achieved; we consider AIO a worthy surgical procedure that has the potential to provide good long-term outcomes similar to those seen with SIO.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns
Authors: Singh Gopal K , Kim, Jr. Isaac E. , Girmay Mehrete , Perry Chrisp , Daus Gem P. , Vedamuthu Ivy P. , De Los Reyes Andrew A. , Ramey Christine T. , Martin, Jr. Elijah K. , Allender Michelle 
Published: September 2019

Objectives: Dramatic increases in opioid and drug overdose mortality have occurred in the United States (US) over the past two decades. To address this national public health crisis and identify gaps in the literature, we analyzed recent empirical trends in US drug overdose mortality by key social determinants and conducted a selective review of the recent literature on the magnitude of the opioid crisis facing different racial/ethnic, socioeconomic, and rural-urban segments of the US population.
Methods: We used the 1999-2017 mortality data from the US National Vital Statistics System to analyze trends in drug overdose mortality by race/ethnicity, age, and geographic area. Log-linear regression was used to model mortality trends. Using various key words and their combinations, we searched PubMed and Google Scholar for select peerreviewed journal articles and government reports published on the opioid epidemic between 2010 and 2018.
Results: Our original analysis and review indicate marked increases in drug overdose mortality overall and by race/ethnicity and geographic regions, with adolescents and young adults experiencing steep increases in mortality between 1999 and 2017. Our selective search yielded 405 articles, of which 39 publications were selected for detailed review. Suicide mortality from drug overdose among teens aged 12-19 increased consistently between 2009 and 2017, particularly among teen girls. The rise of efficient global supply chains has increased opioid prescription use and undoubtedly contributed to the opioid epidemic. Many other important contributing factors to the epidemic include lack of education and economic opportunities, poor working conditions, and low social capital in disadvantaged communities.
Conclusions and Global Health Implications: Our analysis and review indicate substantial disparities in drug overdoses and related mortality, pain management, and treatment outcomes according to social determinants. Increases in drug overdoses and resultant mortality are not only unique to the US, but have also been observed in other industrialized countries. Healthcare systems, community leaders, and policymakers addressing the opioidepidemic should focus on upstream structural factors including education, economic opportunity, social cohesion, racial/ethnic disadvantage, geographic isolation, and life satisfaction.
Key words:
Slimhole Unconventional Well-Design Optimization Enables Drilling Performance Improvement and Cost Reduction
Authors: Schumacker Eric , Volgelsberg Philip 
Published: September 2019

Summary
Slimhole well design can reduce well–construction cost through a reduction in steel, fluids, and disposal costs. In the industry, there has been a misconception that slimhole size involves the tradeoff of slower rate of penetration (ROP) and less–efficient fracture treatment. Improvements in downhole tools, drillstrings, rig capability, and drilling–fluid design have been implemented to improve ROP in slimholes. Completion designs were refined for slimmer holes to avoid any significant loss in stimulation effectiveness and maintain well value. Through systematic replication of learnings and designs across basins, slimhole well design has advanced. Slimhole well design (transition from 8.5/7.875–in. hole and 5.5–in. production casing to 6.75/6.25–in. hole and 5.5/4.5–in. production casing) can reduce unconventional well cost, which reduces well unit-development cost (UDC).
The effects of analgesics and local anesthetics on gene transcription mediated by NFATc2 and Sp1 in pancreatic carcinoma
Authors: Malsy Manuela , Graf Bernhard , Bundscherer Anika 
Published: September 2019

Abstract
Background Pancreatic adenocarcinoma is one of the most lethal cancers worldwide with very poor long-term survival. The treatment of choice next to chemotherapy or radiation treatment is surgical removal of the tumor. However, medication, surgery, and perioperative immunosuppression induce the constitutive activation of important signaling pathways and change the regulation of transcription factors, which may facilitate tumor progression and metastasis. Recent research has identified the transcription factors NFATc2 and Sp1 as key regulators in the carcinogenesis of pancreatic carcinoma. It is still unclear to what extent the transcription factors NFATc2 and Sp1 are influenced by analgesics given via peridural anesthetics or lidocaine infusions administered in perioperative settings or as postoperative pain therapy.Aims To conduct an in vitro analysis of the impact of clinically achievable dosages of ketamine, s-ketamine, metamizole, and paracetamol as well as of sufentanil, ropicavaine, and lidocaine on pancreatic carcinoma cells in dependency of NFATc2 and Sp1.Methods Analgesic stimulation and its effects on the expression of NFATc2 and Sp1 were investigated with immunoblot. Cell proliferation was measured with the ELISA BrdU assay.Results In PaTu8988t pancreatic carcinoma cells, 48h stimulation with ketamine and s-ketamine significantly inhibited proliferation and contemporaneously decreased endogen expression of NFATc2 in the nucleus. The addition of metamizole and lidocaine to PaTu8988t cells reduced proliferation after 48h.Conclusions New treatment concepts target the efficient modulation of specific signaling and transcription pathways. The extent to which drugs influence these mechanisms in vulnerable phases of pancreatic carcinoma cells needs to be investigated in future studies. The basis of novel therapeutic approaches to any disease is detailed knowledge of the carcinogenesis and profound molecular and biological understanding of the mechanisms.
Knowledge, Attitude, and Perceived Barriers Regarding Colorectal Cancer Screening Practices and Risk Factors among Medical Students
Authors: Althobaiti Asma , Jr Hoda 
Published: September 2019

Abstract
Background Colorectal cancer is a major health problem. It is the third most diagnosed common tumor and the fourth leading cause of cancer-related deaths worldwide. Early screening has been shown to decrease the incidence of CRC cancer and decrease mortality. In Saudi Arabia (SA), there is no national policy for CRC screening despite the growing incidence of the disease.This study investigated the knowledge of risk factors for colorectal cancer (CRC), recommendations for screening, and attitudes and barriers towards screening among medical students.Methods Data was collected using a self-administered questionnaire completed by 581 medical students from two Saudi schools. Frequencies and mean scores of knowledge and attitude were determined. The likelihood of students having adequate knowledge of CRC risk factors and screening modalities was estimated using multivariate logistic regression analysis.Results Knowledge of the risk factors for CRC, screening modalities, and attitude towards screening were low in over half of the surveyed medical students. Higher level of medical education and a positive attitude towards CRC screening were independent predictors of higher knowledge levels. Lack of awareness about CRC and screening modalities among patients, and shortage of specialized healthcare providers were barriers independently associated with low knowledge levels.Conclusions Saudi medical students have limited knowledge of and a poor attitude towards CRC screening. These results contribute to our understanding of missed teaching opportunities in Saudi medical schools and suggest intervening at the medical school, clinical practice, and population levesl to increase CRC screening practices.
Single-Stage Repair of Contaminated Hernias Using a Novel Antibiotic-Impregnated Biologic Porcine Submucosa Tissue Matrix
Authors: Minor Samuel Fulton , Brown Carl J , Rooney Paul S , Hodde Jason P , Julien Lisa , Scott Tracy M , Karimuddin Ahmer A , Raval Manoj J , Phang Terry P 
Published: September 2019

Abstract
BackgroundSingle-stage repair of incisional hernias in contaminated fields has a high rate of surgical site infection (30-42%) when biologic grafts are used for repair. In an attempt to decrease this risk, a novel graft incorporating gentamicin into a biologic extracellular matrix derived from porcine small intestine submucosa was developed. MethodsThis prospective, multicenter, single-arm study was designed to determine the incidence of surgical site infection following implantation of the device into surgical fields characterized as CDC Class II, III, or IV. ResultsTwenty-four patients were enrolled, with 42% contaminated and 25% dirty surgical fields. After 12 months, 5 patients experienced 6 surgical site infections (21%) with infection involving the graft in 2 patients (8%). No grafts were explanted. ConclusionsThe incorporation of gentamicin into a porcine-derived biologic graft is associated with a lower than expected rate of device infection for patients undergoing single-stage repair of ventral hernia in contaminated settings. Trial RegistrationThe study was registered March 27, 2015 at www.clinicaltrials.gov as NCT02401334.
Alcohol Use Disorder and Associated Factors Among Jimma University Undergraduate Students
Authors: Alemu Daniel , Tesfaye Elias , Soboka Matiwos , Tesfaye Yonas , Ahmed Gutema 
Published: September 2019

Abstract
Background : Alcohol use among University students is a problem throughout the world. University students are mostly at risk of alcohol use disorders. Alcohol use among students has an association with risky sexual behaviors and mental distress. However; little is known about alcohol use disorders among university students in Ethiopia. Therefore, this study was aimed to assess the prevalence and factors associated with alcohol use disorder among Jimma University undergraduate students. Methods: Institution based cross-sectional study was done among Jimma university students in April 2016. Data were collected from 796 of Jimma University students. Standardized tools, Alcohol Use Disorder Identification Test (AUDIT), Oslo 3 items social support scale (OSS-3) and Kessler-6 (K6), were used to assess alcohol use disorders, social support and psychological distress respectively. Bivariate and multivariable logistic regressions were performed to explore factors associated with alcohol use disorders. Result: The overall prevalence of alcohol use disorders (AUD) among Jimma University undergraduate students was 26.5%.The prevalence of AUDs among females and males was 16.4% and 32.6% respectively. There was a positive association between AUDs and having past history of mental illness (AOR 1.98, 95% CI=1.04, 3.75), having past history of suicidal attempt (AOR 3.63, 95%CI=1.18, 11.11), smoking cigarettes (AOR 5.04, 95%CI=2.02, 12.57), having close friend who drinks alcohol (AOR 2.72, 95%CI=1.76, 4.19) and presence of mental distress (AOR 2.81, 95%CI=1.83, 4.32). Conclusion: The findings of this study showed that the prevalence of alcohol use disorders among Jimma University undergraduate students was high. This implies that the university should establish Anti-alcohol clubs to increase students’ awareness on alcohol and related substances and their harmful outcomes. Keywords: Alcohol use disorders, mental distress, undergraduate students, Ethiopia.
Risk factor analysis for predicting kyphosis reoccurrence of thoracolumbar burst fracture patients treated with posterior short-segment fixation
Authors: An Likun , Zhang Tongtong , Sun Xiangyao , Zhang Xinuo , Sun Siyuan , Hai Yong , Lu Shibao 
Published: September 2019

Abstract
Background The thresholds of risk factors of kyphosis recurrence in thoracolumbar burst fracture patients were still controversial. The aim of this multi-center study was to identify these thresholds.Methods 169 patients were included in this study. Upper intervertebral angle (UIVA), lower intervertebral angle (LIVA), Cobb angle (CA), anterior vertebral height ratio (AVH%), regional angle (RA), posterior vertebral height ratio (PVH%), vertebral wedge angle (VWA), anteroposterior ratio (A/P%), Clinical assessment included Load Sharing Classification (LSC) score, Thoracolumbar Injury Classification and Severity (TLICS) score, Visual Analogue Scale (VAS), and Body mass index (BMI) were perioperatively evaluated. Patients were divided into KR group and none KR (NKR) group according to whether the loss of CA correction was less than 5˚ or not. The risk factors of KR before or after implant removal were analyzed, respectively.Results There were significant improvements in postoperative parameters compared with preoperative parameters, such as AVH%, A/P%, VAS, CA, VWA, PVH% ( P < 0.001, respectively), and UIVA ( P = 0.02). Age (AUC = 0.828) and BMI (AUC = 0.846) were good predictors of KR before implant removal. BMI (AUC = 0.871) was a good predictor of KR after implant removal.Conclusions There were significant differences in risk factors of KR at different postoperative follow-up stages: age > 49 years, BMI > 24 were risk factors of KR before implant removal; BMI > 25.17 was a risk factor of KR.
Performance of black ceramic water filters and their implementation in rural Ecuador
Authors: Guerrero-Latorre Laura , Balseca-Enriquez Priscila , Moyota-Tello Carlos , Bravo-Camino Ronald , Davila-Chavez Stephanie , Bonifaz-Arcos Edison , Romero-Carpio Brigette , Chico-Terán Mayra 
Published: September 2019

Abstract
In rural Ecuador, microbial water contamination is associated with child morbidity mainly due to gastroenteritis. Black ceramic water filters (BCWF) are a new household water treatment recently developed to improve microbial removal from the classical model implemented worldwide. This study has assessed BCWF microbial performance at laboratory level by continuous filtering of spiked water with microbial surrogates (Escherichia coli and MS2 bacteriophage) and highly contaminated surface water to evaluate physicochemical pollutants' removal. At field level, baseline studies in Nanegal and Gualea districts have been performed to evaluate water quality and hygiene practices among communities and a six-month BCWF field implementation study in the Santa Marianita community. Results revealed poor drinking water quality in communities studied. Water treatment practices at household level were reported in low percentages. Conversely, results in BCWF filter assays at laboratory level for 600 litres of usage have shown 5.36 logarithms of bacterial removal and 3.83 logarithms for viral removal and significant reductions of physicochemical pollutants considering international standards. BCWF implementation in the Santa Marianita community reveals promising results on microbial water quality in households using this new technology. However, it is important to reinforce correct BCWF maintenance for better performance at field level.