bluuebunny/crossref_metadata_2025_split huggingface dataset:
Major surgery delegation to mid-level health practitioners in Mozambique: health professionals' perceptions
Authors: Cumbi Amelia , Pereira Caetano , Malalane Raimundo , Vaz Fernando , McCord Colin , Bacci Alberta , Bergström Staffan 
Published: December 2007

Abstract

Background
This study examines the opinions of health professionals about the capacity and performance of the 'técnico de cirurgia', a surgically trained assistant medical officer in the Mozambican health system. Particular attention is paid to the views of medical doctors and maternal and child health nurses.

Methods
The results are derived from a qualitative study using both semi-structured interviews and group discussions. Health professionals (n = 71) were interviewed at both facility and system level. Eight group discussion sessions of about two hours each were run in eight rural hospitals with a total of 48 participants. Medical doctors and district officers were excluded from group discussion sessions due to their hierarchical position which could have prevented other workers from expressing opinions freely.

Results
Health workers at all levels voiced satisfaction with the work of the "técnicos de cirurgia". They stressed the life-saving skills of these cadres, the advantages resulting from a reduction in the need for patient referrals and the considerable cost reduction for patients and their families. Important problems in the professional status and remuneration of "técnicos de cirurgia" were identified.

Conclusion
This study, the first one to scrutinize the judgements and attitudes of health workers towards the "técnico de cirurgia", showed that, despite some shortcomings, this cadre is highly appreciated and that the health delivery system does not recognize and motivate them enough. The findings of this study can be used to direct efforts to improve motivation of health workers in general and of técnicos de cirurgia in particular.
A critical appraisal of guidelines for the management of knee osteoarthritis using Appraisal of Guidelines Research and Evaluation criteria
Authors: Poitras Stéphane , Avouac Jérôme , Rossignol Michel , Avouac Bernard , Cedraschi Christine , Nordin Margareta , Rousseaux Chantal , Rozenberg Sylvie , Savarieau Bernard , Thoumie Philippe , Valat Jean-Pierre , Vignon Éric , Hilliquin Pascal 
Published: December 2007

AbstractClinical practice guidelines have been elaborated to summarize evidence related to the management of knee osteoarthritis and to facilitate uptake of evidence-based knowledge by clinicians. The objectives of the present review were summarizing the recommendations of existing guidelines on knee osteoarthritis, and assessing the quality of the guidelines using a standardized and validated instrument – the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Internet medical literature databases from 2001 to 2006 were searched for guidelines, with six guidelines being identified. Thirteen clinician researchers participated in the review. Each reviewer was trained in the AGREE instrument. The guidelines were distributed to four groups of three or four reviewers, each group reviewing one guideline with the exception of one group that reviewed two guidelines. One independent evaluator reviewed all guidelines. All guidelines effectively addressed only a minority of AGREE domains. Clarity/presentation was effectively addressed in three out of six guidelines, scope/purpose and rigour of development in two guidelines, editorial independence in one guideline, and stakeholder involvement and applicability in none. The clinical management recommendation tended to be similar among guidelines, although interventions addressed varied. Acetaminophen was recommended for initial pain treatment, combined with exercise and education. Nonsteroidal anti-inflammatory drugs were recommended if acetaminophen failed to control pain, but cautiously because of gastrointestinal risks. Surgery was recommended in the presence of persistent pain and disability. Education and activity management interventions were superficially addressed in most guidelines. Guideline creators should use the AGREE criteria when developing guidelines. Innovative and effective methods of knowledge translation to health professionals are needed.
Diversity and evolution of phycobilisomes in marine Synechococcusspp.: a comparative genomics study
Authors: Six Christophe , Thomas Jean-Claude , Garczarek Laurence , Ostrowski Martin , Dufresne Alexis , Blot Nicolas , Scanlan David J , Partensky Frédéric 
Published: December 2007

Abstract
Background
Marine Synechococcus owe their specific vivid color (ranging from blue-green to orange) to their large extrinsic antenna complexes called phycobilisomes, comprising a central allophycocyanin core and rods of variable phycobiliprotein composition. Three major pigment types can be defined depending on the major phycobiliprotein found in the rods (phycocyanin, phycoerythrin I or phycoerythrin II). Among strains containing both phycoerythrins I and II, four subtypes can be distinguished based on the ratio of the two chromophores bound to these phycobiliproteins. Genomes of eleven marine Synechococcus strains recently became available with one to four strains per pigment type or subtype, allowing an unprecedented comparative genomics study of genes involved in phycobilisome metabolism.

Results
By carefully comparing the Synechococcus genomes, we have retrieved candidate genes potentially required for the synthesis of phycobiliproteins in each pigment type. This includes linker polypeptides, phycobilin lyases and a number of novel genes of uncharacterized function. Interestingly, strains belonging to a given pigment type have similar phycobilisome gene complements and organization, independent of the core genome phylogeny (as assessed using concatenated ribosomal proteins). While phylogenetic trees based on concatenated allophycocyanin protein sequences are congruent with the latter, those based on phycocyanin and phycoerythrin notably differ and match the Synechococcus pigment types.

Conclusion
We conclude that the phycobilisome core has likely evolved together with the core genome, while rods must have evolved independently, possibly by lateral transfer of phycobilisome rod genes or gene clusters between Synechococcus strains, either via viruses or by natural transformation, allowing rapid adaptation to a variety of light niches.
Communication during Brief Intervention, Intention to Change, and Outcome
Authors: Daeppen Jean-Bernard , Bertholet Nicolas , Gmel Gerhard , Gaume Jacques 
Published: December 2007

Objectives To explore the relationship between patient's intention to change regarding future alcohol consumption following brief alcohol intervention (BAI) and changes in alcohol consumption 12-months later and the communication characteristics between patient and counselor during BAI. Design, Setting and Subjects Data from 367 patients (experimental arm) of a pragmatic randomized controlled trial were used to assess the effectiveness of BAI among hazardous drinkers attending an Emergency Department (Lausanne University Hospital, Lausanne, Switzerland). Alcohol outcome measures at baseline and 12 months follow-up included usual number of drinks per week, monthly frequency of heavy episodic drinking (5 or more standard drinks for men; 4 or more for women), and the Alcohol Use Disorders Identification Test (AUDIT) score. In addition, the communication characteristics between patient and counselor were analyzed via tape recordings using the Motivational Interviewing Skill Code (MISC) from 97 participants. Patient readiness and importance to change on a 10-point Likert scale (readiness/importance to change ruler) was asked during BAI, and patient intention to change alcohol consumption (yes/no) was asked at the last step. Differences in alcohol outcome at follow-up between the 367 patients who did or did not have an intention to change consumption at baseline were compared, as were differences between these two groups in communication characteristics for the 97 who completed tape recordings. Results Patients with an intention to decrease alcohol consumption reduced alcohol use and related problems more often, and reported higher levels of importance and readiness to change than did their counterparts. Analyses of MISC-coded data showed a significantly higher use of MI-consistent skills among those with a moderation intention, but no group differences on the 8 other counselor communication skills measures were found. Analyses of patient speech during the intervention indicated that those with an intention to change their alcohol consumption significantly more often self-explored personal ambivalence towards alcohol, expressed more intensely their ability, commitment, desire, need and reason to change their alcohol use than did those in the no decrease group. Conclusions The intention expressed by hazardous drinkers when concluding BAI is associated with both patient change talk during BAI and drinking outcome 12 months later, but is mainly independent of counselor communication skills. This intention may be an important clinical indicator of which hazardous drinkers are most likely to improve after BAI.
Glutathione S-transferase- and acetylcholinesterase-inhibiting natural products from medicinally important plants
Authors: Ata Athar , Van Den Bosch Stephanie A. , Harwanik Drew J. , Pidwinski Grant E. 
Published: December 2007

Abstract
Naturally occurring enzyme inhibitors play an important role in a drug discovery program. Glutathione S-transferases (GSTs) play a significant role in the detoxification and metabolism of many xenobiotic and endobiotic compounds. GSTs are considered to be responsible for decreasing the effectiveness of anticancer/antiparasitic agents used for the treatment of cancer and parasitic diseases. The effectiveness of these biomedical agents may be improved by using GST inhibitors as an adjuvant during chemotherapy. Acetylcholinesterase (AChE) inhibitors have potential applications in curing cardiac problems and Alzheimer's disease. This article describes the identification of natural products exhibiting GST and AChE inhibitory activities, from medicinally important plants. Results obtained from the structure-activity relationship (SAR) studies of some of these newly discovered enzyme inhibitors are also discussed.
Chemical ecology = chemistry + ecology!
Authors: Bergström Gunnar 
Published: December 2007

Abstract
Chemical ecology (CE) is an active, interdisciplinary field between chemistry and biology, which, stimulated by natural curiosity and possible applied aspects, has grown to its present position during the last 40-odd years. This area has now achieved a degree of maturity with its own journals, its own international society with annual meetings, and many enthusiastic scientists in laboratories around the world. The focus is on chemical communication and other chemical interactions between organisms, including volatile chemical signals, which guide behaviors linked to various vital needs. It reflects both biodiversity and chemodiversity. All living organisms have these important signal systems, which go back to the origins of life. Successful work in this area has called for close collaboration between chemists and biologists of different descriptions. It is thus a good example of chemistry for biology. The aim of the article is to give a short introduction to the field, with an emphasis on the role of chemistry in a biological context by: giving an overview of the development of the area; showing some examples of studies of chemical communication in insects and plants, basically from our own work; and describing some current trends and tendencies and possible future developments.
Food-dependent Cushing's syndrome: from molecular characterization to therapeutical results
Authors: Albiger N M , Occhi G , Mariniello B , Iacobone M , Favia G , Fassina A , Faggian D , Mantero F , Scaroni C 
Published: December 2007

ObjectiveCortisol secretion in ACTH-independent macronodular adrenal hyperplasia (AIMAH) may be regulated by the aberrant expression of several G-protein-coupled receptors. Bilateral adrenalectomy is the treatment of choice in most cases. We searched for aberrant receptor expression in a patient with AIMAH and evaluated the response to medical and surgical treatment.PatientA 35-year-old woman with amenorrhea, hirsutism, and hypertension presented ACTH-independent cortisol secretion with high androgen levels. Abdominal computed tomography showed bilateral adrenal macronodules (4.5 cm right and 1.0 cm left). Scintigraphy with I131-norcholesterol showed bilateral uptake, prevalent on the right side. Several in vivo stimulation tests were assessed before and after treatment and in vitro studies were performed after unilateral adrenalectomy.ResultsPlasma cortisol increased after a standard meal test (60%) and oral glucose loading (147%), and the response was blunted by pretreatment with 100 μg s.c. octreotide. The therapy with long-acting release octreotide (octreotide-LAR) showed an improvement in urinary free cortisol (UFC) levels. Unilateral adrenalectomy was performed and histopathology revealed macronodular AIMAH. Cortisol and androgens increased after perifusion of tumoral tissue with glucose-dependent insulinotropic polypeptide (GIP), and GIP and LH-receptor overexpression was found in both the adrenal nodules and the adjacent cortex. After surgery, UFC and androgen levels normalized followed by clinical improvement.ConclusionsGIP and LH-receptor expression may coexist in AIMAH, influencing the functional and morphological phenotype. Aberrant hormone receptor expression enables specific pharmacological treatment, but long-term studies are needed to evaluate its real efficacy. Unilateral adrenalectomy may be a safe initial option, particularly for asymmetric bilateral adrenal enlargements.
Endocrine and metabolic responses to extreme altitude and physical exercise in climbers
Authors: Benso Andrea , Broglio Fabio , Aimaretti Gianluca , Lucatello Barbara , Lanfranco Fabio , Ghigo Ezio , Grottoli Silvia 
Published: December 2007

ContextChronic hypoxia induces complex metabolic and endocrine adaptations. High-altitude (HA) exposure is a physiological model of hypoxia.ObjectiveTo further investigate the endocrine and metabolic responses to extreme HA.MethodsWe studied nine male elite climbers at sea level and at 5200 m after climbing Mt. Everest.ResultsAfter 7 weeks at HA, body weight was reduced (P<0.05); regarding endocrine variables we observed: a) an increase of 2-h mean GH concentration (P<0.05) as well as of total IGF-I and IGF binding protein-3 levels (P<0.05 for both); b) a prolactin increase (P<0.05) coupled with testosterone decrease (P<0.01) and progesterone increase (P<0.05) without any change in estradiol levels: c) no change in cortisol, ACTH, and dehydroepiandrosterone sulfate (DHEAS) levels; d) an increase in free thyroxine (P<0.05) and free tri-iodothyronine (T3) decrease (P<0.05) but no change in TSH levels; e) a plasma glucose decrease (P<0.05) without any change in insulin levels; f) an increase in mean free fatty acid levels (P<0.05); g) despite body weight loss, leptin levels showed non-significant trend toward decrease, while ghrelin levels did not change at all.ConclusionsThe results of the present study in a unique experimental human model of maximal exposure to altitude and physical exercise demonstrate that extreme HA and strenuous physical exercise are coupled with specific endocrine adaptations. These include increased activity of the GH/IGF-I axis and a low T3 syndrome but no change in ghrelin and leptin that was expected taking into account body weight decrease. These findings would contribute to better understanding human endocrine and metabolic physiology in hypoxic conditions.
Cut-off limits of the GH response to GHRH plus arginine test and IGF-I levels for the diagnosis of GH deficiency in late adolescents and young adults
Authors: Corneli Ginevra , Di Somma Carolina , Prodam Flavia , Bellone Jaele , Bellone Simonetta , Gasco Valentina , Baldelli Roberto , Rovere Silvia , Schneider Harald Jörn , Gargantini Luigi , Gastaldi Roberto , Ghizzoni Lucia , Valle Domenico , Salerno Mariacarolina , Colao Annamaria , Bona Gianni , Ghigo Ezio , Maghnie Mohamad , Aimaretti Gianluca 
Published: December 2007

ObjectiveTo define the appropriate diagnostic cut-off limits for the GH response to GHRH+arginine (ARG) test and IGF-I levels, using receiver operating characteristics (ROC) curve analysis, in late adolescents and young adults.Design and methodsWe studied 152 patients with childhood-onset organic hypothalamic–pituitary disease (85 males, age (mean±s.e.m.): 19.2±0.2 years) and 201 normal adolescents as controls (96 males, age: 20.7±0.2 years). Patients were divided into three subgroups on the basis of the number of the other pituitary hormone deficits, excluding GH deficiency (GHD): subgroup A consisted of 35 panhypopituitary patients (17 males, age: 21.2±0.4 years), subgroup B consisted of 18 patients with only one or with no more than two pituitary hormone deficits (7 males, age: 20.2±0.9 years); and subgroup C consisted of 99 patients without any known hormonal pituitary deficits (60 males, age: 18.2±0.2 years). Both patients and controls were lean (body mass index, BMI<25 kg/m2). Patients in subgroup A were assumed to be GHD, whereas in patients belonging to subgroups B and C the presence of GHD had to be verified.ResultsFor the GHRH+ARG test, the best pair of highest sensitivity (Se; 100%) and specificity (Sp; 97%) was found choosing a peak GH of 19.0 μg/l. For IGF-I levels, the best pair of highest Se (96.6%) and Sp (74.6%) was found using a cut-off point of 160 μg/l (SDS: −1.3). Assuming 19.0 μg/l to be the cut-off point established for GHRH+ARG test, 72.2% of patients in subgroup B and 39.4% in subgroup C were defined as GHD. In patients belonging to group B and C and with a peak GH response <19 μg/l to the test, IGF-I levels were lower than 160 μg/l (or less than 1.3 SDS) in 68.7 and 41.6% of patients respectively predicting severe GHD in 85.7% of panhypopituitary patients (subgroup A).ConclusionsIn late adolescent and early adulthood patients, a GH cut-off limit using the GHRH+ARG test lower than 19.0 μg/l is able to discriminate patients with a suspicion of GHD and does not vary from infancy to early adulthood.
Novel BSCL2 gene mutation E189X in Chinese congenital generalized lipodystrophy child with early onset diabetes mellitus
Authors: Jin Jing , Cao Lingfeng , Zhao Zhuhui , Shen Shuixian , Kiess Wieland , Zhi Dijing , Ye Rong , Cheng Ruoqian , Chen Lian , Yang Yi , Luo Feihong 
Published: December 2007

ContextCongenital generalized lipodystrophy (CGL) is a rare and heterogeneous disease of autosomal recessive inheritance. Until now, no genetic findings had been reported in Chinese patients with CGL.ObjectiveTo analyze Berardinelli-Seip congenital lipodystrophy type 2 (BSCL2) and 1-acylglycerol-3-phosphate O-acyltransferase 2 (AGPAT2) gene variation in a Chinese boy with CGL and his family.Design, setting, and participantsAll exons of BSCL2 and AGPAT2 with adjacent intron–exon junctions were analyzed using direct sequencing.Main outcome measuresSequences of each exon and nearby intron of the BSCL2 and AGPAT2 genes of the family members were compared with the gene bank genomic sequences.ResultsDNA sequence analysis of the entire coding regions and surrounding uncoding regions disclosed a novel homozygous G→T mutation at nucleotide 909 in exon 5 of the BSCL2 gene in the affected child. A heterozygous state of the G→T mutation of the BSCL2 gene was also found in other family members. This mutation predicts the substitution of glutamic acid at codon 189 by the stop codon (Glu189X or E189X). No variation was found in the AGPAT2 gene.ConclusionE189X is a novel BSCL2 gene mutation that contributes to CGL formation in a family of Chinese origin.
Development and Implementation of a Scale-Management Strategy for Oseberg Sør
Authors: Fleming Niall , Ramstad Kari , Eriksen Synnøve H. , Moldrheim Erlend , Johansen Thomas Rudberg 
Published: December 2007

Summary
Oseberg Sør field, operated by Hydro Oil & Energy, is situated 130 km west of the Norwegian coast on the eastern flank of the Viking Graben structure. It comprises a sequence of fault-bounded structural units of varying geological complexity. Within these units, the reservoir intervals are of moderate to poor quality and can exhibit strong contrasts in permeability and formation water composition. Reservoir support is provided by combined injection of gas and Utsira aquifer water. The wells are a combination of platform and subsea and comprise extended reach horizontals with complex geometry and lesser numbers of vertical wells.
Detailed scale predictions have been performed to identify the scaling risk for each producer. From these, it was identified that the major risk to well performance and integrity was CaCO3 precipitation in the upper tubing with potential failure of the downhole safety valve. The risk varied from negligible to severe and reflected the variable composition of the produced water and well operating conditions. The scale predictions provided the basis for a technical and economic evaluation to identify an appropriate scale-management strategy for Oseberg Sør. For those wells completed with downhole chemical injection lines, the option to use these for scale inhibition was considered cost effective. In other wells where this option was not available, scale inhibitor injection into the gas lift system or squeezing using a viscosified treatment was considered viable.
The paper will provide the technical and economic reasoning for the scale-management strategy selected along with field case histories for each treatment type (i.e., experience with treatment using chemical injection lines, injection of scale inhibitor into the gas lift system, and squeezing).
Field Case Studies: Damage Preventions Through Leakoff Control of Fracturing Fluids in Marginal/Low-Pressure Gas Reservoirs
Authors: Paktinat J. , Pinkhouse J. A. , Williams C. , Clark G. A. , Penny G. S. 
Published: December 2007

Summary
The primary purpose of surfactants used in stimulating sandstone reservoirs is to reduce surface tension and contact angle and provide leakoff control. However, many of these chemicals adsorb rapidly within the first few inches of the sandstone formations, reducing their effectiveness in deeper penetration. This phenomenon causes surfactants to adsorb or plate-out, reducing their effectiveness in post-fracturing fluid recovery.
This study describes experimental and field-case studies of various surfactants used in the oilfield. Several different surfactants, including a nonionic ethoxylated linear alcohol, a nonyl phenol ethoxylate, an amphoteric, a cationic, and a microemulsion system were investigated to determine their adsorption properties when injected into a laboratory sandpacked column. A laboratory-simulated comparison study of commonly used surfactants and microemulsion was used to identify their leakoff and waterrecovery properties from gas wells.
Field data collected from Bradford, Balltown, and Speechley sandstone formations confirmed experimental sandpacked column and core-flow investigations. Reservoirs treated with microemulsion fluids demonstrate exceptional water recoveries when compared with conventional surfactant treatments. Wellhead pressures, flowing pressures, and production data were collected and evaluated using a production simulator to show effective fracture lengths, damage surrounding the fractures, and drainage areas with various fluid systems. These investigations and presented case studies can be used to minimize formation damage.