bluuebunny/crossref_metadata_2025_split huggingface dataset:
The K tree score: quantification of differences in the relative branch length and topology of phylogenetic trees
Authors: Soria-Carrasco Víctor , Talavera Gerard , Igea Javier , Castresana Jose 
Published: September 2007

AbstractSummary: We introduce a new phylogenetic comparison method that measures overall differences in the relative branch length and topology of two phylogenetic trees. To do this, the algorithm first scales one of the trees to have a global divergence as similar as possible to the other tree. Then, the branch length distance, which takes differences in topology and branch lengths into account, is applied to the two trees. We thus obtain the minimum branch length distance or K tree score. Two trees with very different relative branch lengths get a high K score whereas two trees that follow a similar among-lineage rate variation get a low score, regardless of the overall rates in both trees. There are several applications of the K tree score, two of which are explained here in more detail. First, this score allows the evaluation of the performance of phylogenetic algorithms, not only with respect to their topological accuracy, but also with respect to the reproduction of a given branch length variation. In a second example, we show how the K score allows the selection of orthologous genes by choosing those that better follow the overall shape of a given reference tree.Availability: http://molevol.ibmb.csic.es/Ktreedist.htmlContact: jcvagr@ibmb.csic.es
The Poisson Index: a new probabilistic model for protein–ligand binding site similarity
Authors: Davies J.R. , Jackson R.M. , Mardia K.V. , Taylor C.C. 
Published: September 2007

AbstractMotivation: The large-scale comparison of protein–ligand binding sites is problematic, in that measures of structural similarity are difficult to quantify and are not easily understood in terms of statistical similarity that can ultimately be related to structure and function. We present a binding site matching score the Poisson Index (PI) based upon a well-defined statistical model. PI requires only the number of matching atoms between two sites and the size of the two sites—the same information used by the Tanimoto Index (TI), a comparable and widely used measure for molecular similarity. We apply PI and TI to a previously automatically extracted set of binding sites to determine the robustness and usefulness of both scores.Results: We found that PI outperforms TI; moreover, site similarity is poorly defined for TI at values around the 99.5% confidence level for which PI is well defined. A difference map at this confidence level shows that PI gives much more meaningful information than TI. We show individual examples where TI fails to distinguish either a false or a true site paring in contrast to PI, which performs much better. TI cannot handle large or small sites very well, or the comparison of large and small sites, in contrast to PI that is shown to be much more robust. Despite the difficulty of determining a biological ‘ground truth’ for binding site similarity we conclude that PI is a suitable measure of binding site similarity and could form the basis for a binding site classification scheme comparable to existing protein domain classification schema.Availability: PI is implemented in SitesBase www.modelling.leeds.ac.uk/sb/Contact: r.m.jackson@leeds.ac.uk
A District General Hospital pain management programme
Authors: LUSCOMBE F. E. , WALLACE L. , WILLIAMS J. , GRIFFITHS D. P. G. 
Published: September 2007

SummaryA pain management programme was set up in a large District General Hospital to improve the management of the many patients with chronic non‐malignant pain who do not respond to interventional medicine. Outcome measures studied were depression, anxiety, disability, pain locus of control, illness behaviour and patient satisfaction with the programme. The first five of these measures showed statistically significant improvements whilst patient satisfaction with the programme was high at both assessments. In addition, there were marked decreases in the consumption of analgesics and sedative drugs. We conclude that a multidisciplinary pain management programme is a cost effective and constructive way of treating patients whose pain does not respond to interventional management.
The intensive care treatment of convulsive status epilepticus in the UK
Authors: WALKER M. C. , SMITH S. J. M. , SHORVON S. D. 
Published: September 2007

SummarySix hundred and ninety–four members of the Intensive Care Society working in the UK were surveyed by postal questionnaire between May and November 1993 to determine their management of convulsive status epilepticus resistant to initial therapy with intravenous diazepam and phenytoin. Four hundred and eight forms were completed and returned (58.8%). The survey revealed that, following failure of initial management, a benzodiazepine infusion (35%) or anaesthetic induction agent (32%) were the preferred second lines of treatment in intensive care units. In paediatric intensive care units, phenobarbitone (31 %) was the agent of choice. Most respondents (57%) gave anaesthetic induction agents within 60min of the start of status epilepticus, the majority choosing thiopentone (82%). Patients were usually monitored using clinical assessment only (45%), except in paediatric intensive care units and specialist neurological or neurosurgical units where the majority used a cerebral function monitor. Only 12%> of the respondents were aware of a protocol for status epilepticus in their intensive care units. The most frequently used therapeutic and monitoring strategies in the management of refractory status epilepticus in the UK are insufficient and need re–evaluation.
A comparison of three variable performance devices for postoperative oxygen therapy
Authors: McBRIEN M. E. , SELLERS W. F. S. 
Published: September 2007

SummaryEleven patients in the intensive care unit following major abdominal surgery with a nasogastric tube in situ and receiving oxygen via facemask were allocated to receive in a random sequence oxygen at 4l.min‐1 via a Hudson mask, nasal cannulae or a nasal catheter with foam collar at the distal end. A significantly greater Pao2 was achieved using both the nasal catheter with foam collar (p < 0.01) and Hudson mask (p < 0.05) compared to the nasal cannulae. There were no significant differences in the PacO2 or SpO2 values obtained between the devices. In the majority of postoperative patients in whom a variable performance device is indicated, nasal devices appear preferable in terms of patient comfort and compliance. The nasal catheter with foam collar produced a significantly greater PaQ2 than nasal cannulae in patients with a nasogastric tube in situ.
Maternal hypoxaemia during labour and delivery: the influence of analgesia and effect on neonatal outcome
Authors: Griffin R. P. , Reynolds F. 
Published: September 2007

SummaryThe effect of analgesia on the incidence of hypoxaemia was assessed in an unrandomised trial in 51 parturients from the last hour of the first stage of labour until delivery. Women were retrospectively divided into four groups: no analgesia, pethidine with intermittent Entonox, extradural bupivacaine (either infusion of 0.125% or top‐ups of 10ml of 0.25%): and extradural infusion of 0.1% bupivacaine with 2 μg.ml ‐1fentanyl. The lowest median incidence of desaturation (Spo2< 94%) was in the extradural bupivacaine group: 0 min.h‐1 in the last hour of the first stage and 0.1 min.h‐1 in the second stage. The incidence was significantly lower than in the pethidine I Entonox group (1.4min.h‐1) in the last hour of the first stage (p < 0.001) and the extradural bupivacaine /fentanyl group (0.9 min.h‐1 and no analgesia group (3min.h‐1) in the second stage (p < 0.05 in both cases). There was no correlation between maternal oxygenation during the second stage and measures of neonatal outcome including Apgar score and umbilical artery and vein blood gases.
Current management of inadvertent dural taps occurring during the siting of epidurals for pain relief in labour A survey of maternity units in the United Kingdom
Authors: Sajjad T. , Ryan T.D.R. 
Published: September 2007

SummaryA postal survey of all maternity units in the UK was conducted to gain information regarding the management of inadvertent dural taps occurring during the siting of epidurals for pain relief in labour. Of the units surveyed only 58.5% had a written protocol for the management of dural taps. Following their occurrence, 99% of the units resiled the epidural and in 22%, the midwives continued to give the top‐ups. In only one‐third of this latter group was the dose of the top‐up reduced. In 46% of the units, patients who had a dural tap were allowed to push in the second stage of labour. As prophylaxis against the development of headache, 70% of the units infused crystalloids into the epidural space, whereas only 8.6% were in favour of an early prophylactic blood patch.
High frequency jet ventilation in the management of intra‐operative tracheal injury
Authors: Hodgson C. A. , Mostafa S. M. 
Published: September 2007

SummaryA patient undergoing pharyngo‐oesphagectomy with gastric transposition sustained a large tracheal tear during the blind oesophageal dissection. High frequency jet ventilation was successfully employed in the acute airway management and continued postoperatively.
Validation of three paediatric pain scores for use by parents
Authors: WILSON G. A. M. , DOYLE E. 
Published: September 2007

SummaryTwenty children undergoing general surgery and 20 children undergoing otorhinolaryngological surgery were simultaneously assessed on two occasions by a doctor and a parent using three pain scoring systems. The pain scoring systems used were the Objective Pain Score, a four point numerical score and a 100 mm visual analogue scale. There was a high correlation between the scores given by the doctor and by the parents for all three scoring systems with parents consistently giving slightly higher scores than the doctor. The correlation coefficients for parental and medical pain scores in recovery were 0.77 for the Objective Pain Score, 0.70 for the four point numerical score and 0.69 for the visual analogue scale (p < 0.01). At 1 h after leaving the recovery area the correlation coefficients were 0.81, 0.80 and 0.73 respectively (p < 0.01). These results suggest that parental scoring of pain in children will be useful in future audit and research of analgesic regimens, particularly in day‐case surgery.
A comparison of opioid solutions for patient‐controlled epidural analgesia
Authors: SMITH A. J. , HAYNES T. K. , ROBERTS D. E. , HARMER M. 
Published: September 2007

SummarySixty patients took part in a randomised, double‐blind study to compare the analgesic and side effects of three opioid‐containing solutions for patient‐controlled epidural analgesia following abdominal surgery. Patients in group 1 received a solution containing bupivacaine 0.125% with fentanyl 10μg. ml−1, group 2 bupivacaine 0.125% with diamorphine 125μg. ml−1, group 3 pethidine 2.5 mg. ml−1. All groups received 4 ml.h−1 background infusion and 3 ml boluses every 20 min if necessary. There were no significant differences between the groups in visual analogue scale pain scores (p = 0.537) or volumes of solution used at 24 h (p = 0.351) or 48 h (p = 0.105). Motor block was significantly higher in group 2 (p < 0.004) and pruritis occurred significantly less in group 3 (p < 0.05). We conclude that these three solutions produce equivalent analgesia but that pethidine 2.5 mg. ml−1 may be associated with fewer side effects.
Central venous line sepsis in the intensive care unit A study comparing antibiotic coated catheters with plain catheters
Authors: THORNTON J. , TODD N. J. , WEBSTER N. R. 
Published: September 2007

SummaryA randomised controlled clinical trial was undertaken to evaluate the efficacy of antibiotic bonded lines in the reduction of central venous catheter infection. One hundred and seventy‐six plain and bonded catheters were inserted into one hundred and ten patients in an intensive care unit, many of whom were admitted with evidence of sepsis. The catheters used in the study group, which had been pre‐treated by the manufacturers with the cationic surfactant tridodecylmethylammonium chloride, were bonded with vancomycin 1 g made up in 10 ml of water immediately prior to insertion. The catheters used in the control group were neither pre‐treated nor bonded with vancomycin. Eighty percent of control group catheters were infected compared with 62% of study catheters (p = 0.01). The most common organism isolated was coagulase negative staphylococcus. We conclude that antibiotic bonding can reduce central venous catheter infection even in a patient population with a high incidence of sepsis.
Evaluation of the contribution to postoperative analgesia by local cooling of the wound
Authors: BRANDNER B. , MUNRO B. , BROMLEY L. M. , HETREED M. 
Published: September 2007

SummaryThirty healthy patients undergoing lumbar spine surgery were randomly assigned to one of two groups for postoperative pain relief. Group 1 received morphine via patient controlled analgesia and local cooling of the wound by an externally applied cooling pad while group 2 received patient controlled analgesia alone. There was a significant reduction in morphine consumption when local cooling was applied (18.6 mg versus 30.2 mg at 12h, 29.0 mg versus 49.6 mg at 24 h, p < 0.05). Patients were also significantly more satisfied with their overall postoperative pain management when cooling therapy was used.
A double‐blind comparison of codeine and morphine for postoperative analgesia following intracranial surgery
Authors: GOLDSACK C. , SCUPLAK S. M. , SMITH M. 
Published: September 2007

SummaryCodeine and morphine were compared in a double‐blind study of postoperative analgesia in 40 patients after intracranial neurosurgery. Eighteen patients received codeine phosphate 60 mg and 18 morphine sulphate 10 mg, both by intramuscular injection; 4 patients (10%) required no analgesia. Both drugs provided analgesia within 20 min of injection but morphine was more effective than codeine beyond 60 min (p = 0.01). Fewer doses of morphine than codeine were required (p = 0.003). Nine patients requested one dose of morphine and 9 two doses. Seven patients required three doses of codeine and 1 patient required four doses. Neither drug caused respiratory depression, sedation, pupillary constriction or unwanted cardiovascular effects. We conclude that, in the doses used, morphine is a safe alternative to codeine for analgesia after neurosurgery and has a more persistent action.
Carbon monoxide within circle systems
Authors: HARRISON N. , KNOWLES A. C. , WELCHEW E. A. 
Published: September 2007

SummaryAfter reports of carbon monoxide toxicity from the United States, the Medicines Control Agency issued a warning which recommended that soda lime used in circle breathing systems should not be allowed to dry out. We have measured carbon monoxide levels within a circle system in vitro (under a variety of conditions) and in vivo. Carbon monoxide was detected only when a patient was connected to the circle system. As levels in the expiratory limb of the circle system were significantly higher than those in the inspiratory limb, we conclude that the patient acts as the source of carbon monoxide.
Awake fibreoptic intubation in the semi‐prone position following facial trauma
Authors: Neal M. R. , Groves J. , Gell I. R. 
Published: September 2007

SummaryA fit 27‐year‐old man presented with severe facial trauma following an industrial accident. Initial assessment showed severe swelling around the lower jaw and haemorrhage from the mouth, nose, scalp and left ear. The patient was conscious with a Glasgow Coma Score of 13 but in respiratory distress. Following adoption of the prone position his airway improved. Relief of the patient's airway obstruction was a priority and the patient underwent awake fibreoptic intubation in the prone position prior to induction of anaesthesia. Computed tomography scans of his head and neck were unremarkable and after fixation of a bilateral mandibular fracture he made an uneventful recovery. Intubation in the semi‐prone position may be a useful technique in injuries of this type.
Total intravenous anaesthesia with propofol or inhalational anaesthesia with isoflurane for major abdominal surgery: Recovery characteristics and postoperative oxygenation—an international multicentre study
Authors: Phillips A. S. , Mirakhur R. K. , Glen J. B. , Hunter S. C. 
Published: September 2007

SummaryTwo hundred and ten adult patients undergoing open cholecystectomy, vagotomy or gastrectomy were included in a randomised multicentre study to compare postoperative nausea and vomiting, oxygen saturations for the first three postoperative nights, time to return of gastrointestinal function, mobilisation, and discharge from the hospital following induction and maintenance of anaesthesia with propofol and alfentanil or with thiopentone, nitrous oxide, isoflurane and alfentanil. Recovery from anaesthesia was significantly faster in the propofol group (mean (SD) times to eye opening and giving correct date of birth of 14.0 (SD 13.8) and 25.5 (SD 29.5) minutes, and 18.5 (SD 14.8) and 35.5 (SD 37.2) minutes in the propofol and isoflurane groups respectively). There was significantly less nausea in the propofol group (15.4%) than in the isoflurane group (33.7%) in the first two postoperative hours (p < 0.003) but not thereafter. There were no significant differences between the groups in any other recovery characteristics. The incidence of hypoxaemia (arterial oxygen saturation less than 93%) was close to 70% in both groups for the first three postoperative nights, indicating the need for oxygen therapy after major abdominal surgery.
The view of the glottis at laryngoscopy after unexpectedly difficult placement of the laryngeal mask
Authors: Asai T. 
Published: September 2007

SummaryIn 12 patients to whom a non‐depolarising neuromuscular relaxant had been given and in whom placement of the laryngeal mask had failed unexpectedly, the view of the larynx at laryngoscopy and the ease of tracheal intubation were examined. The glottis was only partially seen at laryngoscopy in three patients and was not seen at all in another three patients. Tracheal intubation was difficult in three of them. It would appear that in some patients both placement of the laryngeal mask and tracheal intubation are difficult. It is thus inadvisable to paralyse patients electively and rely on the laryngeal mask to secure a clear airway when tracheal intubation is predicted to be difficult.
Economics of low‐flow anaesthesia in children
Authors: PERKINS R. , MEAKIN G. 
Published: September 2007

SummaryWe have measured the consumption of isoflurane and fresh gas flows in 77 infants and children during 20 all‐day operating sessions using either the enclosed Mapleson A or the circle absorber mode of the Garden‘Ventmasta’ventilator. The average consumption (SD) of isoflurane in 37 patients anaesthetised using the A mode of the Garden system with a mean fresh gas flow of 2.6l.min−1 was 11.1 (4.2)g.h−1, while that in 40 patients anaesthetised using the circle absorber mode with a mean fresh gas flow of 1.21.min−1 was 4.7 (1.0)g.h−1. These figures represent an overall saving of 58% in the use of isoflurane (p < 0.0001) and a mean reduction in fresh gas flow of 54% (p < 0.0001) as a result of using low‐flow anaesthesia. With the addition of small bore breathing hoses the adult circle absorber system was practical to use in both infants and children. These findings should stimulate interest in the use of low‐flow techniques in children.
Pretreatment with controlled‐release morphine for pain after hysterectomy
Authors: CRUICKSHANK R. H. , SPENCER A. , ELLIS F. R. 
Published: September 2007

SummaryIn a double‐blind randomised study, two dosing regimens for controlled‐release morphine tablets were compared against placebo to ascertain the extent of prophylactic postoperative pain control in 51 women undergoing abdominal hysterectomy. One group of patients received controlled‐release morphine every 12 h for 2 days before surgery, a second group received a single dose of controlled‐release morphine 2h before surgery and a third group received placebo. Patient‐controlled analgesia system demands were compared for the first 38 h after surgery and 10‐point pain scores and McGill pain questionnaires were compared for the first 6 postoperative days and at 6 weeks after surgery. During the first 2 days after surgery, patients reported high levels of pain which were similar in all groups. Pain scores on the third and fourth postoperative days were significantly lower in those who had a single pre‐operative dose of controlled‐release morphine compared with placebo and those who had been treated with morphine every 12 hfor 2 days (p = 0.043 and 0.024 for third and fourth day respectively). Patient‐controlled analgesia demands were also fewer and less variable in those patients receiving the single dose of morphine 2h before surgery. The study shows a beneficial analgesic effect of a single pre‐operative dose of morphine, but shows no benefit for a more prolonged pre‐operative dosing regimen.
Effect of epidural block on the lag time of pulse oximeter response
Authors: XUE F. S. , LIAO X. , TONG S. Y. , LIU Q. H. , AN G. , LUO L. K. 
Published: September 2007

SummaryThirty‐six healthy patients, ASA 1, aged 16–41 years, scheduled for elective plastic surgery were studied to determine if thoracocervical or lumbar epidural blocks affected the lag time of the pulse oximeter response. Patients were allocated to receive thoracocervical epidural block (n = 20) (group 1) (lignocaine 1 %) or lumbar epidural block (n = 16) (group 2) (lignocaine 1.5%). Epidural block was performed with a 17‐gauge Tuohy needle inserted in the midline between C7‐T2 vertebrae in group 1 and between L3‐S1 in group 2 and an epidural catheter was introduced. Arterial oxygen saturation (Spo2) was measured continuously using a Datex pulse oximeter. The lag time of the pulse oximeter response was measured while breathing oxygen (100%) after breath‐holding. Values were obtained 10min before and 5, 10, 15, 20, 30, and 40 min after epidural injection of a test dose. There was a progressive decrease in the lag time of the pulse oximeter response so that by 30 min after epidural injection the mean (SD) value had decreased from 29 (6.1) to 14 (3.4) in Group 1 and 41 (12.8) to 23 (7.9) s in group 2 (p < 0.01).
Venous levels of lignocaine and bupivacaine after peribulbar block
Authors: GAO F. , BUDD A. J. 
Published: September 2007

SummaryTwenty‐five patients undergoing elective cataract day surgery were studied after receiving a dual‐injection peribulbar block with a mixture consisting of equal volumes of 2% lignocaine and 0.75% bupivacaine with hyaluronidase. A maximum of 10ml of solution was used for the initial block; supplementary injections of up to 10 ml were given to five patients. Venous blood was taken prior to the block and then 1, 10, 20, 30, 60 and 90 min after the block. The peak mean concentrations of lignocaine (0.722 μg. ml−1) and bupivacaine (0.353 μg. ml−1)were found at 10–20 min after injection when no top‐up was given and at 10 min after the top‐up injection when required. All measured serum concentrations of lignocaine and bupivacaine were below the accepted toxic levels of the two drugs. However, the highest individual toxicity score after a top‐up was 0.915 which was very close to the toxicity threshold (= 1) when a scoring system was used to assess the combined levels.