Surgery‐induced inflammation reduces morphine distribution into cerebrospinal fluid
Bibliographic record
Abstract
Objective To determine the effects of surgery‐induced inflammation on morphine distribution across blood‐brain barrier (BBB) Methods Blood and cerebrospinal fluid (CSF) concentrations of morphine were measured in adult patients undergoing aortic aneurism surgery with (n=12) and without (n=13) cardiopulmonary bypass (CPB). Morphine concentrations were determined by mass‐spectrometry. A Q‐plex cytokine ELISA was used to measure plasma and CSF cytokines. Results The surgical inflammatory response was characterized by increased plasma concentrations IL‐6, a known regulator of BBB drug transporters. The plasma area under the curve from 0 to 24 h (AUC 0–24h ) of interleukin‐6 (IL‐6) was significantly higher (p=0.02) in the CBP (7900±8180 pg/ml h) versus the non‐CPB (1690±1680 pg/ml h) group, indicating that individuals receiving CPB had a more robust inflammatory response. The CSF to plasma AUC 0–24h ratio of morphine in the CPB versus non‐CPB groups was 1.06±0.57 and 2.51±2.08 (p=0.03), respectively, indicating that less morphine penetrated into the brain following CPB when a larger inflammatory response was present. Conclusion CSF morphine exposure is lower in individuals undergoing aortic aneurism with CPB. This effect may be due to IL‐6‐mediated changes in blood‐brain barrier drug uptake or efflux transporter function. The HSFC, PEF and CAS funded the project.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".