bluuebunny/crossref_metadata_2025_split huggingface dataset:
The operational competitiveness of public protected areas managed by Ezemvelo KZN Wildlife
Authors: Motau Karabo D. , Wale Edilegnaw 
Published: March 2018

The purpose of this study was to measure the operational competitiveness of public protected areas (PPAs) in the KwaZulu-Natal province, South Africa. Financial data for ecotourism operations in PPAs were collected from Ezemvelo KZN Wildlife (EKZNW) for 2007–2013, to construct an operational competitiveness profile for each PPA by using a non-parametric method called operational competitiveness rating analysis (OCRA). The results show that permanent staff, utilities, maintenance and repairs, and cost of sales were cost items with the highest average share of total costs, whereas accommodation, admissions, sales and tours, and rides and hikes received higher average shares of total revenues for most PPAs. The identification of the most important cost and revenue items was followed by the computation of resource consumption and revenue generation inefficiency ratings from 2007 to 2013, with the results showing that resource competitiveness had more impact on operational competitiveness relative to revenue competitiveness. This suggests that PPAs under EKZNW can improve operational competitiveness by reducing costs. Ecotourism is an economic incentive used in several countries to encourage biodiversity conservation. Because of declining public funding, conservation agencies such as EKZNW in South Africa should find new sources of funding or find cost-effective ways of managing ecotourism operations.Conservation implications: This information will provide insights into the quality of operational efficiencies of ecotourism activities at EKZNW-controlled PPAs and motivate management to adopt cost-cutting and revenue-increasing strategies to improve operational competitiveness.
Doppler indices of superior thyroid artery in clinically euthyroid adults
Authors: Joish Upendra Kumar , Kavitha Y , Reddy R Harikiran , Prabhu Anitha S , Kumar M Chetan , Siddharth M C 
Published: March 2018

Abstract
Context: Ultrasonography of thyroid gland is a frequently performed investigation. Many of the diffuse thyroid pathologies are associated with altered vascularity. In view of potential applications and scant available data, there is a need to find normal values of Doppler indices of superior thyroid artery (STA). Aims: To find the normal range of Doppler indices like mean peak systolic velocity (PSV), resistivity index (RI), and pulsatility index (PI) of STA in clinically euthyroid adult individuals. Settings and Design: Prospective cross-sectional observational study. Materials and Methods: A study was done in the Department of Radiodiagnosis of a tertiary care hospital, involving clinically euthyroid adult volunteers. Ultrasonography of the thyroid gland with Doppler of bilateral STAs was performed and mean values of PSV, RI, and PI were calculated. Results: A total of 208 subjects, with a mean age of 37.7 years, underwent Doppler evaluation of STA; 148 of them were women and 60 were men. The mean PSV obtained was 16.94 ± 5.3 cm/s. Mean PI and RI were 0.93 ± 0.31 and 0.5 ± 0.13, respectively. There was no significant difference in the values obtained among both the genders. Conclusion: Mean values of Doppler indices of STA in euthyroid individuals have been found in this study.
Sonographic features of invasive ductal breast carcinomas predictive of malignancy grade
Authors: Gupta Kanika , Kumaresan Meenakshisundaram , Venkatesan Bhuvaneswari , Chandra Tushar , Patil Aruna , Menon Maya 
Published: March 2018

Abstract
Context: Assessment of individual sonographic features provides vital clues about the biological behavior of breast masses and can assist in determining histological grade of malignancy and thereby prognosis. Aims: Assessment of individual sonographic features of biopsy proven invasive ductal breast carcinomas as predictors of malignancy grade. Settings and Design: A retrospective analysis of sonographic findings of 103 biopsy proven invasive ductal breast carcinomas. Materials and Methods: Tumor characteristics on gray-scale ultrasound and color flow were assessed using American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) Atlas Fifth Edition. The sonographic findings of masses were individually correlated with their histopathologic grades. Statistical Analysis Used: Chi square test, ordinal regression, and Goodman and Kruskal tau test. Results: Breast mass showing reversal/lack of diastolic flow has a high probability of belonging to histological high grade tumor (β 1.566, P 0.0001). The masses with abrupt interface boundary are more likely grade 3 (β 1.524, P 0.001) in comparison to masses with echogenic halos. The suspicious calcifications present in and outside the mass is a finding associated with histologically high grade tumors. The invasive ductal carcinomas (IDCs) with complex solid and cystic echotexture are more likely to be of high histological grade (β 1.146, P 0.04) as compared to masses with hypoechoic echotexture. Conclusions: Certain ultrasound features are associated with tumor grade on histopathology. If the radiologist is cognizant of these sonographic features, ultrasound can be a potent modality for predicting histopathological grade of IDCs of the breast, especially in settings where advanced tests such as receptor and molecular analyses are limited.
Clinicoradiological aspects of pontine tegmental cap dysplasia: Case report of a rare hindbrain malformation
Authors: Bhayana Aanchal , Bajaj Sunil K , Misra Ritu N , Kumaran S Senthil 
Published: March 2018

AbstractMalformations involving the brainstem are very rare and present with a varied spectrum of clinical symptoms due to multiple cranial nerve palsies and pyramidal tract involvement. Of these, pontine tegmental cap dysplasia is a very unusual malformation, characterized by ventral pons hypoplasia and an ectopic dorsal band of tissue, projecting into the fourth ventricle, from dorsal pontine tegmentum. A 4-year-old male child, presenting with left facial nerve palsy, revealed hypoplastic ventral pons and an ectopic structure on magnetic resonance imaging (MRI). The ectopic structure was isointense to pons, arose from the left side of dorsal pontine tegmentum, at pontomedullary junction and protruded into the fourth ventricle, impinging upon the left seventh and eighth cranial nerves. Diffusion tensor imaging (DTI) depicted abnormal white matter tracts in ectopic tissue with absent transverse pontine fibres and abnormal middle and superior cerebellar peduncles. The typical MRI appearance, coupled with DTI, helped us reach an accurate diagnosis of pontine tegmental cap dysplasia, in a setting of neurological dysfunction.
Comparative diagnostic test accuracy of post-esophagectomy water-soluble computed tomography and fluoroscopic swallow studies: A meta-analysis
Authors: Murray Timothy E , Morrin Martina 
Published: March 2018

Abstract
Aims: Both fluoroscopic water-soluble contrast swallow (FWSCS) and CT water-soluble contrast swallow (CTWSCS) are widely performed as a routine in the post-esophagectomy patient to assess for anastomotic leak. Several prospective studies have compared FWSCS and CTWSCS; however, no synthesis of the data exists. Materials and Methods: Systematic review and meta-analysis of diagnostic test accuracy studies comparing FWSCS and CTWSCS in the adult patient following esophagectomy for malignancy was performed in accordance with PRISMA guidelines. Results: Three diagnostic test accuracy studies met the inclusion criteria, directly comparing FWSCS and CTWSCS in 185 patients. FWSCS demonstrated high specificity (98%), but low sensitivity (64%). CTWSCS can be categorized as normal, mediastinal gas without contrast leak, or leakage of oral contrast. Visible leakage of oral contrast demonstrated high specificity (98%) but low sensitivity (56%). The presence of mediastinal gas increased sensitivity (84%), but reduced specificity (85%). The higher sensitivity of CTWSCS over FWSCS failed to reach significance (P = 0.125). Conclusion: CTWSCS shares the high specificity of FWSCS. Its higher sensitivity increases its utility as a rule-out test in the postoperative period. Additional factors that may influence decision-making are described.
Portal vein thrombosis after donor liver biopsy: Case report
Authors: Bashir Shahnawaz , Mittal Kartik , Khisti Rohit , Yadav Ankusha , Mukund Amar , Pamecha Viniyendra 
Published: March 2018

AbstractPercutaneous plugged liver biopsy is a safe procedure with a low complication rate. Portal vein thrombosis has not been reported after percutaneous liver biopsy in the literature. We present a case of portal vein thrombosis after percutaneous plugged liver biopsy in a voluntary liver donor, which was subsequently treated with catheter-directed percutaneous transhepatic thrombolysis. In future, healthy patients undergoing liver biopsies are expected to increase for donor evaluation. More refinements of technique and hardware in the future may further decrease the rate of complications. However, if they occur, they need to be recognized and managed at the earliest.
Primary presentation of Jeune’s syndrome as gastric motility disorder in an infant: A case report
Authors: Katyan Amit , Grover Shabnam Bhandari , Rajani Heena , Bagga Deepak , Antil Neha 
Published: March 2018

AbstractWe report a case of a 4-week-old female neonate with Jeune’s asphyxiating thoracic dystrophy (JATD) and coexistent situs anomaly, primarily presenting as gastric motility disorder. The child presented with abdominal distension and nonbilious vomiting since birth with failure to thrive. However, skeletal survey revealed JATD. Upper gastrointestinal contrast study showed situs inversus with delayed gastric emptying. Pyloric biopsy and intraoperative antro-duodenal manometry confirmed association of gastric motility disorder. Awareness of the unusual possibility of primary presentation of Jeune syndrome as gastric motility disorder will improve the management approach in such infants.
Brown fat necrosis with calcifications in the newborn: Risk factors, radiographic findings, and clinical course
Authors: Golden Eleza T , Dickson Paula , Simoneaux Stephen 
Published: March 2018

Abstract
Objective: To describe the radiographic appearance of subclinical calcified brown fat necrosis and the associated clinical and laboratory findings. Materials and Methods: Picture Archiving and Communications Sytem (PACS) was searched using keywords “soft tissue calcification” and “chest.” The clinical record was searched for prior cardiac surgery, bypass, Extracorporeal Membrane Oxygentation (ECMO) and prostaglandin use. Age when calcifications were first detected, location, resolution, and associated laboratory abnormalities were recorded. Results: Nine patients were identified. None had skin lesions. All patients had congenital heart disease and had experienced cardiac/respiratory arrest and/or severe hypotension 1–6 weeks before soft tissue calcifications occurred. Calcifications resolved by 9 weeks to 5 months in 3 patients. The remaining were either deceased or lacked follow-up imaging. Renal ultrasound was performed in all but 1 patient. Nephrocalcinosis was only seen in 1 patient. Conclusion: Brown fat necrosis is subclinical, diagnosed on plain film, and likely self-limited. It occurs in term and preterm infants who have undergone significant systemic stress and carries a poor prognosis.
From JTS to Riverside Church: The Relationship Between Torah min Hashamayim and Heschel's Political Activism
Authors: Cohen Aryeh 
Published: March 2018

Abstract
This article argues that the impetus for Abraham Joshua Heschel's activism, contra Heschel himself, is found in the first part of his magnum opus—Torah min Hashamayim be-Aspaclarya shel HaDorot. It will argue that Heschel's activism is a religious solution to a theological problem, a problem which is spelled out as the tension between Rabbi Ishmael and Rabbi Akiva. Heschel describes God as suffering with Israel. This suffering (according to Rabbi Akiva) is an instance of the partnership between God and Israel. It will further suggest that this is a uniquely Heschelian model of what Oscar Romero, referred to as the transfiguration. Finally, it argues that Romero's transfiguration theology can help illuminate a part of Heschel's framing of Heavenly Torah which has largely gone unnoticed or has been ignored.
Diagnosing Soil and Coconut Root Existence in Lontang Plantation of Manado City
Authors: Tamod Zetly Estefanus , Kumolontang Wisje , Kaunang Djony 
Published: March 2018

Province of North Sulawesi has been known as wave palm area (coconut). One of the plantations (coconut) potential become the farmer’s income and Locally-Generated Revenue (LGR). Therefore, it is important to maximize the soil function and root system of coconut. This research was aimed to diagnose a soil and coconut root existence in Lontang Plantation of Manado City. Soil observations were carried out on a single stretch of coconut plantations owned by community. The observation was done through the soil profile at a spacing of <1 m; 3 m and 5 m from the main tree of the coconut. The results showed that decreasing of C-Organic content in 1 m depth was not followed by enhancement of soil content weight, because C-Organic has spread equally in middle state and into the depth of >1 m on 3 and 5 m spacing profile from the main tree which categorized as low. Existence of total root length (Lrv) and dry root weight (Drv) shows that deeper soil will be more reduced of the root Lrv and Drv values along with the organic material in the bottom layer (> 1 m) lower than above it. The highest Lrv and Drv average value is located on the depth of 0 – 60 cm. Specrol existence on 1 - 3 m spacing profile have showed many soft roots which grow on these spacing. The soft root has a roles to absorb nutrient and water for the plant and direct contact with the soil.
Integrated Nutrient Management of an Acid Paddy Soil in Karang Tanjung Village, Padang Ratu, Central Lampung
Authors: Kasno Antonius , Irawan Irawan , Husnain Husnain , Rochayati Sri 
Published: March 2018

Balanced fertilization is the key factor to improve the efficiency and effectiveness of fertilization.The dosage of inorganic fertilizers applied can be determined based on the nutrient status of P, K and rice productivity. The research aims to improve balance fertilization that combines inorganic fertilizers, which is set up based on soil nutrient status, and organic fertilizers. The research was conducted in Karang Tanjung Village, Padang Ratu District, Central Lampung, in the dry season of 2009 until 2012. An experimental plot of one hectare was set up in the farmer’s paddy fields. Generally, the plot for every treatment was owned by two or more farmers. The treatments consisted of the dose of fertilizer applications for lowland rice, namely (1) dose of fertilizers based on farmer practice, (2) dose of fertilizers proposed by Petrokimia, (3) 75% of fertilizer dose that was set up based on soil analysis plus straw compost, and (4) 75% of inorganic fertilizer combined with manure and biofertilizer. At the fourth growing season, each plot was applied with 100% inorganic fertilizer (NPK fertilizer). The results showed that the limiting factor of the soil used in the current study is the content of organic-C, N, K, and CEC. The compost of rice straw used as organic matter in the current study contains higher organic-C and total-N in comparison to manure. Organic matter application in the form of straw compost or manure can reduce 25% of NPK application, while the production of rice remains high. Fertilization on paddy soils based on soil nutrient status can improve fertilization efficiency. Rice production in the treatment of 100% NPK is similar to that in the fertilization treatments based on farmer practice and Petrokima rate. Keywords: Nutrient management, acid soil, fertilization efficiency
A hypertension control quality improvement pilot program: Experiences and blood pressure outcomes from physician practices
Authors: Khan Tamkeen , Yang Jianing , Barkowski Laken , Tapper Beth , Lubomski Lisa , Daniel Donna , Wozniak Gregory 
Published: March 2018

Improving Health Outcomes: Blood Pressure (IHO: BP) was a Quality Improvement (QI) pilot program developed by the American Medical Association (AMA) and Johns Hopkins Medicine aimed at helping physicians and their care teams better manage patients with uncontrolled hypertension. The pilot study was conducted at 10 ambulatory practice sites between October 2013 and November 2014 in which the initiative was to devise a framework and intervention strategies for improving hypertension control. The program included evidence-based tools and materials to support the Measure Accurately, Act Rapidly, and Partner with Patients (M.A.P.) framework, interactive components with coaching support and peer-to-peer learning opportunities, and a measurement system supported by health technology, all intended to aid blood pressure management. This paper captures the learnings from the engagement, experiences, and satisfaction of care teams from the IHO: BP pilot that were used to adjust, reassess, and refine components of the QI program. Overall, participation in the IHO: BP pilot was associated with an increase in BP control rates from a mean of 69% to 75% (p < .05) for 3 of the 10 practices. Mean systolic and diastolic blood pressure was reduced in 8 of 10 practices by a mean of 12.5 mmHg/6.5 mmHg (p < .05). Furthermore, evaluation of participant experiences indicated that 75% of the respondents were satisfied or very satisfied with the initiative. The results from this study include components of the pilot that participants indicated were most helpful and were used to generate useful information for hypertension QI efforts that were later scaled and spread to subsequent initiatives.
Genome Editing in Neuroepithelial Stem Cells to Generate Human Neurons with High Adenosine-Releasing Capacity
Authors: Poppe Daniel , Doerr Jonas , Schneider Marion , Wilkens Ruven , Steinbeck Julius A. , Ladewig Julia , Tam Allison , Paschon David E. , Gregory Philip D. , Reik Andreas , Müller Christa E. , Koch Philipp , Brüstle Oliver 
Published: March 2018

Abstract
As a powerful regulator of cellular homeostasis and metabolism, adenosine is involved in diverse neurological processes including pain, cognition, and memory. Altered adenosine homeostasis has also been associated with several diseases such as depression, schizophrenia, or epilepsy. Based on its protective properties, adenosine has been considered as a potential therapeutic agent for various brain disorders. Since systemic application of adenosine is hampered by serious side effects such as vasodilatation and cardiac suppression, recent studies aim at improving local delivery by depots, pumps, or cell-based applications. Here, we report on the characterization of adenosine-releasing human embryonic stem cell-derived neuroepithelial stem cells (long-term self-renewing neuroepithelial stem [lt-NES] cells) generated by zinc finger nuclease (ZFN)-mediated knockout of the adenosine kinase (ADK) gene. ADK-deficient lt-NES cells and their differentiated neuronal and astroglial progeny exhibit substantially elevated release of adenosine compared to control cells. Importantly, extensive adenosine release could be triggered by excitation of differentiated neuronal cultures, suggesting a potential activity-dependent regulation of adenosine supply. Thus, ZFN-modified neural stem cells might serve as a useful vehicle for the activity-dependent local therapeutic delivery of adenosine into the central nervous system.
The role of suboptimal mitochondrial function in vulnerability to post‐traumatic stress disorder
Authors: Preston Graeme , Kirdar Faisal , Kozicz Tamas 
Published: March 2018

AbstractPost‐traumatic stress disorder remains the most significant psychiatric condition associated with exposure to a traumatic event, though rates of traumatic event exposure far outstrip incidence of PTSD. Mitochondrial dysfunction and suboptimal mitochondrial function have been increasingly implicated in several psychopathologies, and recent genetic studies have similarly suggested a pathogenic role of mitochondria in PTSD. Mitochondria play a central role in several physiologic processes underlying PTSD symptomatology, including abnormal fear learning, brain network activation, synaptic plasticity, steroidogenesis, and inflammation. Here we outline several potential mechanisms by which inherited (genetic) or acquired (environmental) mitochondrial dysfunction or suboptimal mitochondrial function, may contribute to PTSD symptomatology and increase susceptibility to PTSD. The proposed pathogenic role of mitochondria in the pathophysiology of PTSD has important implications for prevention and therapy, as antidepressants commonly prescribed for patients with PTSD have been shown to inhibit mitochondrial function, while alternative therapies shown to improve mitochondrial function may prove more efficacious.
Pregnancy management and outcome in patients with four different tetrahydrobiopterin disorders
Authors: Kuseyri O. , Weissbach A. , Bruggemann N. , Klein C. , Giżewska M. , Karall D. , Scholl‐Bürgi S. , Romanowska H. , Krzywińska‐Zdeb E. , Monavari A. A. , Knerr I. , Yapıcı Z. , Leuzzi V. , Opladen T. 
Published: March 2018

AbstractIntroductionInborn errors of tetrahydrobiopterin (BH4) biosynthesis or recycling are a group of very rare neurometabolic diseases. Following growing awareness and improved availability of drug treatment the number of patients with BH4 disorders reaching adulthood is constantly increasing. Pregnancy care of patients with these disorders is therefore a new challenge for clinicians.MethodsThis retrospective study summarises for the first time clinical and biochemical monitoring data of 16 pregnancies in seven women with different disorders of BH4 metabolism and evaluates treatment regimens before and during pregnancy in relation to the obstetrical outcome and paediatric follow‐up.ResultsWorsening of pre‐existing neurological symptoms or occurrence of new symptoms during pregnancy was not observed in most of the cases. Treatment regimens remained mostly unchanged. Pregnancies were not complicated by disease‐specific features. Organ abnormalities, miscarriage, prematurity, IUGR and chromosomal changes were occasionally reported, without showing any association with the standard drug treatment for BH4 deficiencies.ConclusionAlthough our data on 16 pregnancies in seven patients did not present any association of standard drug treatment with an increased rate of pregnancy complications, abnormal obstetrical or paediatric outcome, an intensive clinical and biochemical supervision by a multidisciplinary team before, during and after the pregnancy in any BH4 deficiency is essential since available data on pregnancies in patients with BH4 deficiencies is limited.