bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Phase III, Double-blind, Placebo-controlled, Multicenter Study on the Efficacy of Recombinant Human Antithrombin in Heparin-resistant Patients Scheduled to Undergo Cardiac Surgery Necessitating Cardiopulmonary Bypass
Authors: Avidan Michael S. , Levy Jerrold H. , Scholz Jens , Delphin Elise , Rosseel Peter M. J. , Howie Michael B. , Gratz Irwin , Bush Charles R. , Skubas Nikolaos , Aldea Gabriel S. , Licina Michael , Bonfiglio Laura J. , Kajdasz Daniel K. , Ott Elizabeth , Despotis George J. 
Published: January 2005

Background
The study evaluated the efficacy of recombinant human antithrombin (rhAT) for restoring heparin responsiveness in heparin resistant patients undergoing cardiac surgery.

Methods
This was a multicenter, randomized, double-blind, placebo-controlled study in heparin-resistant patients undergoing cardiac surgery with cardiopulmonary bypass. Heparin resistance was diagnosed when the activated clotting time was less than 480 s after 400 U/kg heparin. Fifty-four heparin-resistant patients were randomized. One cohort received 75 U/kg rhAT, and the other received normal saline. If the activated clotting time remained less than 480 s, this was considered treatment failure, and 2 units fresh frozen plasma was transfused. Patients were monitored for adverse events.

Results
Only 19% of patients in the rhAT group received fresh frozen plasma, compared with 81% of patients in the placebo group (P < 0.001). During their hospitalization, 48% of patients in the rhAT group received fresh frozen plasma, compared with 85% of patients in the placebo group (P = 0.009). Patients in the placebo group required higher heparin doses (P < 0.005) for anticoagulation. There was no increase in serious adverse events associated with rhAT. There was increased blood loss 12 h postoperatively (P = 0.05) with a trend toward increased 24-h bleeding in the rhAT group (P = 0.06). There was no difference between the groups in blood and platelet transfusions.

Conclusion
Treatment with 75 U/kg rhAT is effective in restoring heparin responsiveness and promoting therapeutic anticoagulation in the majority of heparin-resistant patients. Treating heparin-resistant patients with rhAT may decrease the requirement for heparin and fresh frozen plasma.
Cricoid Pressure Does Not Increase the Rate of Failed Intubation by Direct Laryngoscopy in Adults
Authors: Turgeon Alexis F. , Nicole Pierre C. , Trépanier Claude A. , Marcoux Sylvie , Lessard Martin R. 
Published: January 2005

Background
Cricoid pressure (CP) is applied during induction of anesthesia to prevent regurgitation of gastric content and pulmonary aspiration. However, it has been suggested that CP makes tracheal intubation more difficult. This double-blind randomized study evaluated the effect of CP on orotracheal intubation by direct laryngoscopy in adults.

Methods
Seven hundred adult patients undergoing general anesthesia for elective surgery were randomly assigned to have a standardized CP (n = 344) or a sham CP (n = 356) during laryngoscopy and intubation. After anesthesia induction and complete muscle relaxation, a 30-s period was allowed to complete intubation with a Macintosh No. 3 laryngoscope blade. The primary endpoint was the rate of failed intubation at 30 s. The secondary endpoints included the intubation time, the Cormack and Lehane grade of laryngoscopic view, and the Intubation Difficulty Scale score.

Results
Groups were similar for demographic data and risk factors for difficult intubation. The rates of failed intubation at 30 s were comparable for the two groups: 15 of 344 (4.4%) and 13 of 356 (3.7%) in the CP and sham CP groups, respectively (P = 0.70). The grades of laryngoscopic view and the Intubation Difficulty Scale score were also comparable. Median intubation time was slightly longer in the CP group than in the sham CP group (11.3 and 10.4 s, respectively, P = 0.001).

Conclusions
CP applied by trained personnel does not increase the rate of failed intubation. Hence CP should not be avoided for fear of increasing the difficulty of intubation when its use is indicated.
Type 2 Diabetes Mellitus and the Catabolic Response to Surgery
Authors: Schricker Thomas , Gougeon Rejeanne , Eberhart Leopold , Wykes Linda , Mazza Louise , Carvalho George , Carli Franco 
Published: January 2005

Background
The authors tested the hypothesis that the catabolic responses to colorectal surgery are amplified in the presence of type 2 diabetes mellitus.

Methods
Seven nondiabetic and seven diabetic patients underwent a 6-h stable isotope infusion study (3 h fasted, 3-h glucose infusion at 4 mg . kg . min) on the second postoperative day. Leucine rate of appearance (Ra), leucine oxidation, nonoxidative leucine disposal, and glucose Ra were assessed by L-[1-C]leucine and [6,6-H2]glucose. Circulating concentrations of glucose, lactate, insulin, glucagon, and cortisol also were determined.

Results
Diabetic patients had a higher leucine oxidation than nondiabetic patients (P = 0.0003), whereas leucine Ra and nonoxidative leucine disposal were not different. Administration of glucose did not affect leucine kinetics regardless of whether patients were diabetic. In diabetic patients, glucose Ra was greater than in the nondiabetic group (P = 0.0032). Glucose infusion suppressed the endogenous glucose Ra to a lesser extent in diabetic than in nondiabetic patients (P = 0.0048). Plasma glucose concentrations were higher in diabetic than in nondiabetic patients (P = 0.0203), both in the postabsorptive and the fed state. Circulating concentrations of glucagon were higher (P = 0.0065) and concentrations of insulin were lower (P = 0.0146) in the presence of diabetes, resulting in a lower insulin/glucagon ratio (P = 0.0002). In diabetic patients, the insulin/glucagon ratio increased during glucose infusion to a lesser extent than in the nondiabetic group (P = 0.0014).

Conclusion
Protein catabolism after colorectal surgery is increased in patients with type 2 diabetes mellitus as reflected by an increased oxidative protein loss.
Human Kidneys Play an Important Role in the Elimination of Propofol
Authors: Takizawa Daisuke , Hiraoka Haruhiko , Goto Fumio , Yamamoto Koujirou , Horiuchi Ryuya 
Published: January 2005

Background
Extrahepatic clearance of propofol has been suggested because its total body clearance exceeds hepatic blood flow. However, it remains uncertain which organs are involved in the extrahepatic clearance of propofol. In vitro studies suggest that the kidneys contribute to the clearance of this drug. The purpose of this study was to confirm whether human kidneys participate in propofol disposition in vivo.

Methods
Ten patients scheduled to undergo nephrectomy were enrolled in this study. Renal blood flow was measured using para-aminohippurate. Anesthesia was induced with vecuronium (0.1 mg/kg) and propofol (2 mg/kg) and then maintained with nitrous oxide (60%), sevoflurane (1 approximately 2%) in oxygen, and an infusion of propofol (2 mg . kg . h). Radial arterial blood for propofol and para-aminohippurate analysis was collected from a cannula inserted in the radial artery. The renal venous sample and the radial arterial sample were obtained at the same time after the steady state of propofol was established.

Results
The renal extraction ratio of propofol was 0.58 +/- 0.15 (mean +/- SD). The renal clearance of propofol was 0.41 +/- 0.15 l/min (mean +/- SD), or 27 +/- 9.9% (mean +/- SD) of total body clearance.

Conclusion
Human kidneys play an important role in the elimination of propofol.
Halothane and Isoflurane Do Not Directly Interact with Cardiac Cross-bridge Function
Authors: Vivien Benoît , Lecarpentier Yves , Riou Bruno , Coirault Catherine 
Published: January 2005

Background
Halogenated anesthetics depress myocardial contractility by altering a number of specific mechanisms. These alterations include decreases in inward calcium current and sarcoplasmic reticulum function and reduced calcium myofilament sensitivity. However, the direct effects of volatile anesthetics on cross-bridge function have yet to be precisely determined.

Methods
Myosin monomers and actin filaments were isolated from fresh rat left ventricles and rabbit skeletal muscles, respectively. Halothane or isoflurane was added at concentrations equivalent to 1 and 2 minimum alveolar concentration (MAC). Motility of actin filaments over myosin was initiated by adding 2 mm adenosine triphosphate and was analyzed at 30 degrees C. Maximum actomyosin adenosine triphosphatase activity and the association constant of myosin for actin were determined from a double-reciprocal Lineweaver-Burk plot of the adenosine triphosphatase rate versus actin concentration. A known inhibitor of actomyosin function, 2,3-butanedione 2-monoxime (2 mm), was used in positive control experiments. Data are presented as mean +/- SD.

Results
Motility velocities driven by myosin were not significantly different between baseline and 1 and 2 MAC halothane (2.70 +/- 0.33, 2.72 +/- 0.36, and 2.70 +/- 0.40 microm/s, respectively). Similarly, motility velocities driven by myosin were not significantly different between baseline and 1 and 2 MAC isoflurane (2.73 +/- 0.33, 2.72 +/- 0.37, and 2.72 +/- 0.40 microm/s, respectively). Neither of the two halogenated anesthetics, at any concentration tested, significantly modified the maximum actomyosin adenosine triphosphatase activity or the association constant of myosin for actin as compared with baseline. 2,3-Butanedione 2-monoxime induced a drastic reduction in both motility velocity and maximum actomyosin adenosine triphosphatase activity.

Conclusion
These results indicate that isoflurane and halothane do not directly depress the mechanical or enzymatic properties of cross-bridges in the heart.
Continuous Peripheral Nerve Blocks at Home for Treatment of Recurrent Complex Regional Pain Syndrome I in Children
Authors: Dadure Christophe , Motais Frederic , Ricard Christine , Raux Olivier , Troncin Rachel , Capdevila Xavier 
Published: January 2005

Background
Recurrent complex regional pain syndrome I is not rare in the pediatric population. The authors conducted this study to evaluate the efficacy of continuous peripheral nerve blocks with elastomeric disposable pumps associated with initial Bier blocks for the treatment of recurrent complex regional pain syndrome I in children.

Methods
After parental informed consent, 13 children who did not respond to conventional complex regional pain syndrome treatment were included (mean age, 13 yr; range, 9-16 yr). After general anesthesia, peripheral nerve block was performed using 0.5 ml/kg lidocaine, 1%, with epinephrine and 0.5% ropivacaine injected in the peripheral nerve block catheter. Then, a 20-min Bier block was performed using a tourniquet and 0.2 ml/kg lidocaine, 1%; 3 ml/kg hydroxyethyl starch 130/06; and 5 mg/kg buflomedil injected intravenously. A solution of 0.1 ml . kg . h continuous ropivacaine, 0.2%, was infused through the catheter using an elastomeric pump for 96 h. Need for rescue analgesia, occurrence of side effects, and status of motor and sensory block were recorded at hours 1, 6, 12, 24, 48, 72, and 96. Children and parents completed a satisfaction assessment. All of the children had follow-up visits after 2 months.

Results
Postoperative analgesia was excellent. The median pain score was 0 for each period studied. Motor blockade was minimal before 12 h (median, 1) and absent thereafter. One child needed rescue analgesia. All children were able to walk easily after the initial 24-h period (walking score, > 4). Children and parents were all satisfied. Children returned home under parental surveillance beginning in the 24th hour. Neither peripheral nerve block nor Bier block caused side effects. After 2 months, none of the children exhibited any clinical symptom of recurrent complex regional pain syndrome.

Conclusion
Ambulatory continuous peripheral nerve block associated with an initial Bier block seems to be a significant and novel contribution to treat recurrent pediatric complex regional pain syndrome I. It allows complete pain relief, early mobilization, and rapid return home, representing a psychological advantage for these children.
Intraoperative Remifentanil Infusion Does Not Increase Postoperative Opioid Consumption Compared with 70% Nitrous Oxide
Authors: Lee Libby H. Y. , Irwin Michael G. , Lui Siu-kuen 
Published: January 2005

Background
Remifentanil is commonly used to replace nitrous oxide in general anesthesia to avoid the side effects of the latter. However, there are reports that intraoperative remifentanil infusion can lead to acute opioid tolerance. In this study, the authors tried to determine the dose of remifentanil comparable in efficacy to 70% nitrous oxide and to evaluate its effect on postoperative pain and morphine consumption after colorectal surgery using isoflurane anesthesia.

Methods
Sixty adult patients undergoing open colorectal surgery were randomly assigned to receive either remifentanil or 70% nitrous oxide along with isoflurane anesthesia. After morphine analgesia titration in the postanesthesia care unit, patient-controlled analgesia was commenced. Morphine consumption and pain were scored at rest and during cough or movement for 24 h.

Results
The mean remifentanil infusion rate was 0.17 mug . kg . min. The median visual analog pain score on arrival in the postanesthesia care unit was 1 (0-10) in the nitrous oxide group and 3 (0-9) in the remifentanil group (P < 0.05). Otherwise, there was no difference in pain scores at 5, 10, and 15 min and no difference in the total morphine consumption during the stay in the postanesthesia care unit. The two groups had similar total morphine consumption in the first 24 h and pain scores at rest and during movement. The incidence of postoperative nausea and vomiting was 10% in both groups. There was no difference in the sedation scores.

Conclusion
The substitution of 70% nitrous oxide with remifentanil at a mean infusion rate of 0.17 mug . kg . minute for colorectal surgery did not affect postoperative opioid consumption.
Evolution of DNA Sequence Nonhomologies among Maize Inbreds
Authors: Brunner Stephan , Fengler Kevin , Morgante Michele , Tingey Scott , Rafalski Antoni 
Published: January 2005

AbstractAllelic chromosomal regions totaling more than 2.8 Mb and located on maize (Zea mays) chromosomes 1L, 2S, 7L, and 9S have been sequenced and compared over distances of 100 to 350 kb between the two maize inbred lines Mo17 and B73. The alleles contain extended regions of nonhomology. On average, more than 50% of the compared sequence is noncolinear, mainly because of the insertion of large numbers of long terminal repeat (LTR)-retrotransposons. Only 27 LTR-retroelements are shared between alleles, whereas 62 are allele specific. The insertion of LTR-retrotransposons into the maize genome is statistically more recent for nonshared than shared ones. Most surprisingly, more than one-third of the genes (27/72) are absent in one of the inbreds at the loci examined. Such nonshared genes usually appear to be truncated and form clusters in which they are oriented in the same direction. However, the nonshared genome segments are gene-poor, relative to regions shared by both inbreds, with up to 12-fold difference in gene density. By contrast, miniature inverted terminal repeats (MITEs) occur at a similar frequency in the shared and nonshared fractions. Many times, MITES are present in an identical position in both LTRs of a retroelement, indicating that their insertion occurred before the replication of the retroelement in question. Maize ESTs and/or maize massively parallel signature sequencing tags were identified for the majority of the nonshared genes or homologs of them. In contrast with shared genes, which are usually conserved in gene order and location relative to rice (Oryza sativa), nonshared genes violate the maize colinearity with rice. Based on this, insertion by a yet unknown mechanism, rather than deletion events, seems to be the origin of the nonshared genes. The intergenic space between conserved genes is enlarged up to sixfold in maize compared with rice. Frequently, retroelement insertions create a different sequence environment adjacent to conserved genes.
Potential use of real‐time data capture and job‐tracking technology in the field
Authors: McAndrew Seán T. , Anumba Chimay J. , Hassan Tarek M. , Duke Alistair K. 
Published: January 2005

PurposeThe purpose of the paper is to discuss the scope for improving the delivery of FM services through the use of wireless web‐based communications infrastructure, delivered via an application service provider (ASP) business model. This paper discusses the findings from case studies of three organisations and their approach to the management of facilities.Design/methodology/approachAn investigation was undertaken to ascertain the current state of play in terms of managing and tracking processes within the facilities management department of three different organisations. These case studies were chosen from distinct sectors, namely health care, higher education, and banking. Emphasis is placed on analysing how the organisations currently operate with their existing FM systems and the degree of influence technology has on existing processes. This was considered mainly in terms of computer‐aided facilities management (CAFM) and computer‐integrated facilities management (CIFM).FindingsThe study found that a new wireless web‐based service for FM systems would be considered useful. Although notoriously slow adopters of new technology, there was an acceptance by the facilities managers interviewed that a wireless web‐based approach would improve current practice, especially with respect to real‐time job reporting and tracking and in the determination of FM operative working time utilisation.Practical implicationsFurther work by the author is focusing on the development of a suitable demonstrator to illustrate the key concepts of a wireless web‐based FM service which will then be tested and evaluated. For further information, visit the research project web site at www.wirelessfm.org Originality/value – The paper hopefully stimulates discussion in the area of emerging wireless technologies that have the potential to streamline and improve current practices for the management of facilities, in particular that of real‐time job reporting and tracking.
A framework model for outsourcing asset management services
Authors: Hassanain Mohammad A. , Al‐Saadi Saleh 
Published: January 2005

PurposeThe aim of this paper is to present a framework model for outsourcing asset management services in municipalities.Design/methodology/approachThe authors have analysed the outsourcing of asset management services in the municipal sector. A survey document containing a series of questions was developed and issued to administrative (policy‐making) staff members at senior management level. These staff members are concerned with the strategic planning of facilities beyond the five‐year horizon.FindingsThe survey indicated that outsourcing is being utilized in almost all functions relating to the management of municipal infrastructure, and that the criterion for selecting a specific contractor for a service is lowest price. The findings section in the paper also presents a list of the advantages of outsourcing along with the rated priority of each, the disadvantages of outsourcing along with the rated severity of each, and the strategies that could be followed to achieve a successful outcome from the outsourcing process, along with the rated importance of each.Originality/valueDevelopment of the model was motivated by the desire to develop a standard methodology that senior managers in the municipalities can adopt as a reference policy guideline for the conduct of outsourcing of asset management services. The model builds on knowledge from the published literature and professional practice documented in the municipality of the City of Dammam, one of the largest cities in the Eastern Province of Saudi Arabia. The model serves to standardize process descriptions, the activities that need to be undertaken, and the methodology of how and what information needs to be communicated between activities. The framework also may provide a useful focus for others wishing to enter the outsourcing area.
Determination of domestic flushing water consumption in Hong Kong
Authors: Wong L.T. , Mui K.W. 
Published: January 2005

PurposeTo determine the domestic flushing water consumption for a building development.Design/methodology/approachA statistic mathematical model is proposed and the model parameters are sampled with the Monte Carlo sampling technique. The frequency distribution of the parameters for Hong Kong is identified from the survey results of the water closet usage patterns in five typical residential building estates. In particular, the density function of the diurnal variations of occupant load and flushes per occupant, and the cistern volume of the water closets in 597 apartments are used to establish the model.FindingsThe flushing water consumption of the residential developments in Hong Kong is determined and compared with the measurement result of typical residential buildings.Research limitations/implicationsThe model parameters are not exhaustive and are determined from surveys in Hong Kong, which perhaps limits the model's usefulness elsewhere.Practical implicationsA useful source of reference in determining the domestic flushing water consumption of building developments for those involved in building design and management related to the flushing water systems of residential buildings.Originality/valueThis paper proposes a statistical mathematical model of domestic flushing water consumption and presents a template to determine the required model parameters. The model offers practical help to professionals involved in planning, designing and managing the flushing water facilities for domestic buildings.
Analysis and optimization of the thermal performance of microchannel heat sinks
Authors: Liu Dong , Garimella Suresh V. 
Published: January 2005

PurposeTo provide modeling approaches of increasing levels of complexity for the analysis of convective heat transfer in microchannels which offer adequate descriptions of the thermal performance, while allowing easier manipulation of microchannel geometries for the purpose of design optimization of microchannel heat sinks.Design/methodology/approachA detailed computational fluid dynamics model is first used to obtain baseline results against which five approximate analytical approaches are compared. These approaches include a 1D resistance model, a fin approach, two fin‐liquid coupled models, and a porous medium approach. A modified thermal boundary condition is proposed to correctly characterize the heat flux distribution.FindingsThe results obtained demonstrate that the models developed offer sufficiently accurate predictions for practical designs, while at the same time being quite straightforward to use.Research limitations/implicationsThe analysis is based on a single microchannel, while in a practical microchannel heat sink, multiple channels are employed in parallel. Therefore, the optimization should take into account the impact of inlet/outlet headers. Also, a prescribed pumping power may be used as the design constraint, instead of pressure head.Practical implicationsVery useful design methodologies for practical design of microchannel heat sinks.Originality/valueClosed‐form solutions from five analytical models are derived in a format that can be easily implemented in optimization procedures for minimizing the thermal resistance of microchannel heat sinks.