bluuebunny/crossref_metadata_2025 huggingface dataset:
Accountability and control in a cat's cradle
Authors: Berry Anthony J.
Published: May 2005

Purpose

To examine control and accountability in an expressive organisation.

Design/methodology/approach

The paper was based upon a longitudinal case study of events in the Church of England from 1994 to 2001 and was based on documents, debates in the governing body, conversations and interviews and participants' observation.

Findings

As a response to a financial crisis a group of financiers from within the Evangelical theological tradition (which places stress on headship and control) proposed the creation of a new church governance body (a national council) with strongly integrated central control and severely diminished conciliar participation. This group described the complex church organisations and structures (disparagingly) as “a cats cradle of autonomous and semi autonomous organizations”. This conflicted with the values of the other covenant traditions (Anglo‐Catholic and Liberal). The new body was created, but the proposed centralised control was unraveled, the existing constitution and governance was maintained, the “cats cradle” was enriched within the ground metaphor of autonomy. The case shows how the loosely coupled nature of this expressive institution with its multiple theological (value and belief) stances and multiple organisations, relationships and accountabilities was almost impervious to the attempt to shift them into an ordered and controlled hierarchy.

Research limitations/implications

The great complexity of an ancient Church constrains the researcher to a limited account.

Practical implications

Change in expressive organisations happens by emergent negotiation and cannot be directed because the various value positions infuse everything.

Originality/value

The conception of control and accountability as being constructed and reconstructed in the interplay of the constructs of covenant, constitution and contract. This theorising may have a wider application both to expressive, public institutions and private organisations.
Born again accountants
Authors: Burrowes Ashley , Novicevic Milorad
Published: May 2005

Purpose

To call for more critical reflection in accounting to avoid business disasters and raise public confidence.

Design/methodology/approach

Poetic exposition.

Findings

Observes recent business disasters and identifies a lack of critical examination of current accounting directions as a significant contributor to these failings.

Research limitations/implications

Points to issues requiring further critical study in the accounting field.

Originality/value

Offers a unique interpretation of current business problems.
Notes from “The Rabbit Hole”
Authors: Özmen Uysal Özgür
Published: May 2005

Purpose

A satirical reflection on the role and perception of accountants.

Design/methodology/approach

Poetic exposition.

Originality/value

A unique critique of the accounting world.
Chip packaging challenges … a roadmap based overview
Authors: Longford Andy
Published: May 2005

Purpose

To provide an insight and view of the expected directions for microelectronic packaging, at chip level, that ties in current developments to the needs envisaged by emerging technology roadmaps.

Design/methodology/approach

The requirements for packaging semiconductor devices have become a new technology driver for the electronics “Final Manufacturing” industry. In line with forecasts and roadmaps, the expected multitude of options are being developed in order to meet the demand of an industry which requires ever more complex devices which exhibit both higher reliability and lower cost.

Findings

As application potentials develop, so package cost becomes the driver. In turn, low cost package solutions are becoming the drivers for new technologies such as “last‐mile” fibre optic Telecom systems, 3G phones, bluetooth and sensors. MEMS devices are a key example of how applications are pushing the technologies to create cost effective packaging.

Research limitations/implications

The emerging packaging technologies, currently BGA's and chip size packaging's (CSP), continue to develop to meet the needs of electronic devices, driven by the “smaller, faster, cheaper” paradigm. However the final manufacturing and testing aspects of such needs are often overlooked and as such the test industry faces a number of severe challenges in terms of handling these new package technologies.

Practical implications

By looking at the market trends and how these new technologies are developing, especially with respect to emerging developments in CSP, flip chip and wafer level packaging, solutions for many of the challenges posed can be determined.

Originality/value

This paper provides a market analysis of the trends and directions of the chip packaging industry. It has taken data from a wide number of sources of market information and compared the expectations of each to actual emerging applications. The resulting information is expected to become a benchmark for this aspect of the semiconductor manufacturing industry.
Reliability assessment for SnPb solder and Ag‐Pd bond pad metallization
Authors: Choon Teo Kiat , Lin Ting Yu
Published: May 2005

Purpose

To predict the reliability life for SnPb solder and Ag‐Pd bond pad metallization. The aim of selected artificial aging using temperature shock test (TST) and high temperature storage test (HTS). These tests are produced in a short time, the same deterioration in solder joint strength that would occur by natural aging in the actual field condition of up to 10 years or 5,000 h service life.

Design/methodology/approach

This paper using Arrhenius model describes the results of TST and HTS. The TST is aimed to verify the resistance of the assembly to cyclic temperature loading. The HTS test is aimed to check the effect of inter‐diffusion between solder and component and substrate finish, on the mechanical strength of the joints. The paper is organized in four sections: introduction, experimental procedure, experimental results and discussion, conclusion and recommendation.

Findings

The accelerated aging procedures used in this study had successfully modified mainly the outer surface and the interface between a solderable coating and the base metal. The tests that rely on higher temperature increase the diffusivity and the reactivity of the species and so modify internal interfaces such as the intermetallic compound layer, as well as the surface oxide layer. This has provided an effective screening test in understanding the reliability field performance.

Research limitations/implications

For future work it is recommended to run HTS at 175C to validate the estimate for the effective activation energy for diffusion. Next, perform scanning electron microscopy & energy dispersive X‐ray (SEM/EDX) analysis to compare results at 150C for SMD components and studs and explain the different behaviour. Finally, continue T‐shock testing to 2000 cycles.

Practical implications

This has provided an effective screening test in understanding the reliability field performance.

Originality/value

This paper provides a cost effective and practical procedure in screening test for SnPb Solder and Ag‐Pd bond pad metallization. It is an effective solution to electronic manufacturing industry.
A faster power MOSFET device with electrical stress treatment
Authors: Salame C. , Habchi R. , Tazibt W. , Khoury A. , Mialhe P.
Published: May 2005

Purpose

The aim of this paper is to provide some specific information on the effects of DC voltage stress on the current, rise time (Tr) and fall time (Tf), at switching between on and off state of power n‐MOSFET devices.

Design/methodology/approach

A constant positive electrical stress voltage technique is used to study the devices in this work by giving the gate a positively bias with respect to source and a short circuit of the drain with the grounded source. Voltage stress is gradually increased by automatic 1 V step until it reaches the max tolerated value by the gate dielectric (70 V for device studied in this paper). Response of the device for electrical stress was measured for different doses (stress time).

Findings

The experimental results show that the rise time increases the beginning of stress dose and then it almost stabilises with time, while fall time decreases at first and then starts to increase for higher stress time. The modification of the device switching time parameters were associated to positive oxide charge and interface state Si/SiO2 effects.

Originality/value

This paper offers new information concerning a very important field in microelectronic devices where the switching speed of the components becomes a major requirement. The technique used to improve the device speed has a very low cost and a simple feasibility.
The School for Field Studies Centre for Coastal Studies
Authors: Farrell T.A. , Ollervides F.
Published: May 2005

Purpose

To present the School for Field Studies‐Centre for Coastal Studies (SFS‐CCS) study abroad Mexico program, and consider its relative success as a sustainable development education program.

Design/methodology/approach

The SFS‐CCS academic model and results of its implementation are presented. Program success is discussed by applying sustainable development education criteria found in the literature, and by sharing feedback from SFS‐CCS students, affiliates and clients. Examples of two student projects are also presented to consider program success.

Findings

The SFS‐CCS academic model structure, which includes a five‐year research plan, an interdisciplinary and case study approach, and integration of client needs and community projects, have helped the school meet its sustainable development education goals. Student research projects have also resulted in positive sustainable development outcomes for the surrounding community of Puerto San Carlos.

Practical implications

A description of the components of the academic model and recommendations made related to create similarly effective models are provided for study abroad and other sustainable development education institutions.

Originality/value

This paper recognizes how a study abroad program can contribute knowledge and lessons learned as part of the larger, global dialogue of how to provide successful sustainable development education.
A case study in applying lean sustainability concepts to universities
Authors: Comm Clare L. , Mathaisel Dennis F.X.
Published: May 2005

Purpose

To apply the concepts of lean and sustainability to higher education.

Design/methodology/approach

A questionnaire was developed, administered to 18 public and private universities and analyzed.

Findings

The focus in higher education is now on cost reduction or budget containment initiatives. Although these initiatives were not implemented with the knowledge that they were implementing “lean” practices, their application has often reduced waste, improved operational efficiency, and contributed to sustainability.

Research limitations/implications

This is a preliminary study with a sample size of 18 universities in the northeastern United States. Future research should include more universities in the United States as well as in other countries.

Practical implications

The participating universities in this study shared their beliefs about how “lean” thinking can contribute to the sustainability of higher education. Other universities can “learn from their lessons”.

Originality/value

Very little past research, except in the area of green marketing, has focused on lean sustainability concepts in higher education.
Introducing a new business course: “Global business and sustainability”
Authors: Marshall R. Scott , Harry Sean P.
Published: May 2005

Purpose

To outline the themes, topics and material used in a new course, Global business and sustainability, for business educators interested in integrating this emergingparadigm into their courses.

Design/methodology/approach

The structure, design and reference materials for the Global business and sustainability course are reviewed. Specific challenges in designing the course are discussed. Recommendations are provided on how key frameworks developed for this course can aid in the delivery of a business course integrating sustainability concepts.

Findings

Compared to a more traditional business course, in a business course integrating sustainability concepts there is greater need for delineating the relationships between institutional, industry and corporate level factors linked to sustainability issues. However, a business course developed around the principles of sustainability is also similar to any other course in the business curriculum in that it needs to demonstrate the link between competitive actions and outcomes. Finally, sustainable development and sustainability are concepts that, in principle, should appeal and apply across cultural and national boundaries.

Practical implications

A useful source of information for business educators planning to integrate sustainability issues and concepts into their courses.

Originality/value

This paper addresses an important emerging paradigm and offers practical advice on how to incorporate this paradigm into business curriculum.
Library users in human information behaviour
Authors: Steinerová Jela , Šušol Jaroslav
Published: May 2005

Purpose

Aims to study human information behaviour as part of the research project on the interaction of man and the information environment (project VEGA 1/9236/02) and to analyse library users' information behaviour on both sides of the information coin – information usage and information production/publishing.

Design/methodology/approach

The methodology was composed of the following steps: pilot studies of students' information‐seeking behaviour; a large‐scale questionnaire survey of users of academic and research libraries; data analyses and interpretations; verification of hypotheses; multiple data sorting; and modelling of user groups.

Findings

Library users appreciate easy access and well‐organised forms of information, with an emphasis on electronic sources. In their capacity as authors of professional papers, only few subjects considered print and electronic publishing to be equal. Two user types have been derived from the data analysis. Type S manifests pragmatic ways of information seeking and appreciates the low cost and speed of electronic publishing. Type A is characterised by analytic, in‐depth information processing, stressing the prestige and review process of print publishing.

Research limitations/implications

Quantitative methods can form a starting‐point for typologies of human information behaviour. Additional qualitative methods, especially interviews with students, focus groups and observations, are planned for future research into modelling of users' information behaviour.

Originality/value

Based on the analysis, two information‐seeking styles have been identified: strategic and analytic. Differences between the search styles suggest that systems designers, knowledge managers and libraries should be open to the creative use and representation of electronic information, taking into account different information behaviours.
The impact of electronic information delivery on reference enquiries
Authors: Murray Janet , Tschernitz Cindy
Published: May 2005

Purpose

This paper seeks to examine the impact of greater access to electronic information, both free and fee‐based, on reference enquiries.

Design/methodology/approach

The research methodology included an extensive literature review and interviews with reference services librarians both in Australia and overseas.

Findings

The assumption that greater internet access and use equal a decline in public and state library reference enquiries is not proven.

Originality/value

The paper concludes with a summary of trends, predictions and scenarios of usage of state and public library reference services in an increasingly electronic age, paying special attention and emphasis to the Australian environment.
Indigenous database development in Indian research and development library and information centres
Authors: Kanaujia Sukula Shiva
Published: May 2005

Purpose

The present paper aims to study the development of indigenous databases and their benefits for library users in libraries and information centers in the research and development institutions of the Council of Scientific & Industrial Research of North India and to discuss the role of indigenous databases, their development and impact.

Design/methodology/approach

The study used a survey methodology. Data were collected through a detailed questionnaire, together with interviews, and analyzed by dividing the concepts into themes, such as: factors responsible for developing indigenous databases; perceptions and attitude of librarians regarding indigenous databases; database forms and formats; database development from a national perspective; database maintenance, services and marketing.

Findings

The findings reveal that indigenous database development is currently taking place and it has future potential. Librarians have positive attitudes towards the different aspects of indigenous databases, as library information products/services. The study recommends that efforts be made to increase user‐awareness and to create a broader knowledge resource. Instead of scattered approaches and different styles, a coherent approach needs to be taken.

Research limitations/implications

Only North Indian laboratories have been surveyed, so the study does not provide a complete picture of indigenous science and technology (S&T) databases.

Practical implications

The study is a useful source of information about the development of indigenous databases in the Indian S&T environment.

Originality/value

This paper fulfils an identified information/resource need and provides information about the current development of indigenous databases in India.
Google Scholar: the pros and the cons
Authors: Jacsó Péter
Published: May 2005

Purpose

To identify the pros and the cons of Google Scholar.

Design/methodology/approach

Chronicles the recent history of the Google Scholar search engine from its inception in November 2004 and critiques it with regard to its merits and demerits.

Findings

Feels that there are massive content omissions presently but that, with future changes in its structure, Google Scholar will become an excellent free tool for scholarly information discovery and retrieval.

Originality/value

Presents a useful analysis for potential users of the Google Scholar site.
The role of social capital in the relationship between human capital and career mobility
Authors: Lin Shu‐Chi , Huang Yin‐Mei
Published: May 2005

Purpose

This study aims to examine what kind of role social capital plays in the relationship between human capital and career outcomes, with a particular focus on testing the mediation and moderation models.

Design/methodology/approach

Using data compiled from 111 employees at three financial institutions in Taiwan, social capital was measured by employees based on network in‐degree centrality, and development potential was measured by supervisors.

Findings

Results showed that the effects of human capital on developmental potential were fully mediated by social capital. Moreover, employees with firm‐specific human capital, managerial positions and longer tenure, received higher potential evaluations by their supervisors through their central positions.

Research limitations/implications

The study shed light on the direct and significant effects of social capital on developmental potential, while human capital should translate into social capital to get positive career outcomes. That is, it is social capital that transforms human capital into workplace gains, e.g. producing positive career outcomes and increasing supervisors' perception of potential.

Practical implications

Employees should make best use of social capital transformed from human capital to obtain positive career outcomes in the organizations.

Originality/value

Support for the authors' mediation model suggests that both social capital and careers literature can be enhanced though integration. It follows that future research on career outcomes would benefit from the inclusion of social capital variables.
An evaluation of the Balanced Scorecard® in equity valuation
Authors: Wang Wanncherng
Published: May 2005

Purpose

To examine the value relevance of the Balanced Scorecard (BSC) for equity valuation.

Design/methodology/approach

The investigations are based on the empirical relationships between a set of BSC indicators and the exchange ratios for a sample of 32 mergers and acquisitions (M&As) of 14 financial holding companies. Data sources are collected from machine‐readable database, annual financial reports, industry reports and professional magazines. The study period covers years 2000‐2002.

Findings

First, the BSC indicators explain as high as 90 percent of the variations of the exchange ratios. Consistent with the spirit of BSC, non‐financial performance measures play an important role in the valuation of financial institutions, incrementally improving about 40 percent of explanatory power. Second, empirical evidence shows that acquiring firms outperform the acquired firms and target firms outperform the non‐target firms in terms of BSC measures.

Research limitations/implications

The small sample size and the limited set of the BSC indicators may constrain the applicability of the results to other industries and time periods.

Practical implications

The empirical results provide a concrete and practical framework for the valuation of intangibles and the application of the BSC in M&As.

Originality/value

The study examines the BSC as a framework for the valuation of intangibles. The empirical results support the usefulness of the BSC in equity valuation and further corroborate a number of extant theories in the M&A literature.
Larval development of five species of blenny (Teleostei: Blenniidae) from the western central North Atlantic, with a synopsis of blennioid family characters
Authors: Ditty J. G. , Shaw R. F. , Fuiman L. A.
Published: May 2005

Light trap collections on oil and gas platforms in the northern Gulf of Mexico off Louisiana from 1995 to 1997 contained young of tessellated blenny Hypsoblennius invemar, freckled blenny Hypsoblennius ionthas, featherduster blenny Hypleurochilus multifilis, molly miller Scartella cristata and seaweed blenny Parablennius marmoreus, which are described. Interspecific differences were: number of dorsal, anal, pelvic and caudal fin elements; number of mandibular pores; presence or absence of canine teeth, hypural 5 and pectoral fin pigment; width of gill openings; length of preopercular spines (in larvae). Size at settlement differed among some taxa, but all five species settled within a narrow size window of c. 1·5 mm standard length (LS). Hypsoblennius invemar, H. ionthas, H. multifilis and S. cristata settled at mean sizes between 11·3 and 12·1 mm LS, whereas P. marmoreus settled at a mean size of 19·3 mm LS. Sexually dimorphic differences were consistently evident by 17–18 mm LS in all species but P. marmoreus. The two smallest blennies with external characters normally associated with sexual maturity were a 20 mm male and 21 mm female H. multifilis. Primary caudal fin rays began to bifurcate between 17·0 and 18·3 mm LS in H. invemar, H. ionthas, H. multifilis and S. cristata. Hypleurochilus multifilis displayed the external characteristics of being sexually mature at 20–21 mm LS. Thus, bifurcation of primary caudal fin rays was an indicator of approaching sexual maturity in H. multifilis and this may also be true in the other species studied.
Nocturnal density patterns of Atlantic salmon parr in the Sainte‐Marguerite River, Québec, relative to the time of night
Authors: Bédard M.‐E. , Imre I. , Boisclair D.
Published: May 2005

The number of visible Atlantic salmon Salmo salar parr in the Sainte‐Marguerite River, Québec, increased between 2030 and 2230 hours then remained relatively stable until 0230 hours. Moon phase did not appear to influence the number of visible parr. There were more fish closer to the shore than to the middle of the stream.
Melanism in the gastric mucosa of the scalloped ribbonfish from the Ligurian Sea
Authors: Bottaro M. , Ferrando S. , Ferrando T. , Psomadakis P. N. , Vacchi M.
Published: May 2005

Internal stomach melanism was observed in two scalloped ribbonfish Zu cristatus from the Ligurian Sea. The phenomenon may help prevent advertizing the presence of this species after consumption of bioluminescent prey.
Swim or hide: predator cues cause species specific reactions in young fish larvae
Authors: Lehtiniemi M.
Published: May 2005

The anti‐predator behaviour of first‐feeding (9 mm total length) hatchery‐reared pike Esox lucius larvae and wild‐caught three‐spined stickleback Gasterosteus aculeatus larvae was studied in the presence of chemical and visual signals from a fish predator. The results clearly showed that both fish species detected the predator by chemical signals alone but the combined chemical and visual signals caused stronger and more diverse reactions. Subsequent to predator detection, their swimming activity decreased, they attacked zooplankton less frequently and spent more time in the vegetation. Fishes differed in their anti‐predator responses. Pike reacted more clearly to chemical signals alone while three‐spined stickleback needed both chemical and visual cues to assess the predation risk. The strongest reaction was the reduction in swimming activity in the three‐spined stickleback (38% decrease) and a decrease in attack rate of the pike (39% decrease), but only when a refuge was available. Pike were more dependent on the vegetation cover showing almost no anti‐predator responses in the absence of a refuge. In addition, there was a difference in the refuge use of three‐spined stickleback between different macrophytes, indicating a complex or dense structure, which was difficult to penetrate or chemical excretion in one of them.
Early development in the annual fish Cynolebias viarius
Authors: Arezo M. J. , Pereiro L. , Berois N.
Published: May 2005

The detailed characteristics and timing of early development in Cynolebias viarius, an annual fish endemic to Uruguay, were obtained from in vivo observations of embryos cultured under standardized laboratory conditions. The chorion ultrastructure is reported for this species for the first time. Comparison with previous data from other annual fishes showed that C. viarius exhibited the longest early development including cleavage, blastula formation and epiboly.
Muscle fine structure reflects ecotype in two nototheniids
Authors: Sänger A. M. , Davison W. , Egginton S.
Published: May 2005

The fine structure of swimming (pectoral) and myotomal (axial) skeletal muscle and myocardium of two species of Antarctic nototheniid fishes were studied by electron microscopy, comparing the cryopelagic Pagothenia borchgrevinki and the benthic Trematomus bernacchii. Mean fibre size varied by a factor of four among muscles within each species and may have reflected the locomotory power available, being larger in pectoral oxidative (red) and axial glycolytic (white) muscle of P. borchgrevinki. Both species use labriform locomotion, and the more active P. borchgrevinki had a greater capillary supply, expressed as a capillary to fibre ratio, than T. bernacchii to both red (3·48 ± 0·36 v. 1·63 ± 0·14, mean ± s.e.; P < 0·01) and white (2·70 ± 0·20 v. 1·53 ± 0·18, mean ± s.e.; P < 0·01) regions of the pectoral musculature. The greater aerobic scope of P. borchgrevinki was strikingly demonstrated in the higher mitochondrial content of all skeletal muscle types sampled, and the ventricular myocardium (0·269 ± 0·011 v. 0·255 ± 0·012 mean ± s.e.; P < 0·05). Minor differences were found in other elements of fibre composition, with the exception of a five‐fold greater lipid content in pectoral red fibres of P. borchgrevinki(0·074 ± 0·014 mean ± s.e.)v. T. bernacchii(0·010 ± 0·003; P < 0·05). Differences in muscle fine structure among species clearly reflected differences in their ecotype.
Does light intensity affect self‐feeding and food wastage in group‐held rainbow trout and white‐spotted charr?
Authors: Noble C. , Mizusawa K. , Tabata M.
Published: May 2005

The self‐feeding rhythms of rainbow trout Oncorhynchus mykiss and white‐spotted charr Salvelinus leucomaenis were studied when group‐held fishes (n = 10 per group) were fed using self‐feeders under two different light intensities (50 lx, 16 μW cm−2 and 700 lx, 215 μW cm−2) during the light phase of the light‐dark cycle. Food wastage was also measured. At 50 lx, all groups of rainbow trout learned to operate the self‐feeder within 4 days, whereas it took up to 25 days for all groups at 700 lx. In contrast, all groups of white‐spotted charr learned self‐feeding within 17 days, irrespective of light intensity. These results, although non‐significant, suggest that lower light intensities can stimulate instrumental learning in rainbow trout, but not white‐spotted charr. In rainbow trout, the total number of trigger actuations for the entire experimental period was significantly higher at 50 rather than 700 lx, although this may have been related to delayed learning at 700 lx. There was no significant effect in white‐spotted charr. Growth rate (assessed using the thermal growth coefficient) was also higher in rainbow trout but not white‐spotted charr at 50 rather than 700 lx, although this difference was non‐significant. Light intensity had no significant effect on food wastage in either rainbow trout or white‐spotted charr, and it did not appear to affect the proportion of trigger actuations during the light phase. Clear diurnal feeding rhythms were observed in both species and these were classified into four categories: uniform, dawn, dusk and crepuscular. At 50 lx, fish from both species generally fed in temporally localized periods at either dawn and dusk, whilst feeding was predominantly uniform during the light phase at 700 lx.
New data on the systematics and interrelationships of sawfishes (Elasmobranchii, Batoidea, Pristiformes)
Authors: Deynat P. P.
Published: May 2005

New characters based on the arrangement and morphology of dermal denticles show that sawfishes can be divided into two distinctive groups. The first group, comprising the knifetooth sawfish Anoxypristis cuspidata, is characterized by tricuspid denticles variably located on both dorsal and ventral parts of the body. The second group is represented by species of the genus Pristis, showing an uniform and homogenous dermal covering of monocuspidate denticles on both dorsal and ventral sides of the body and within the buccopharyngeal cavity. Pristis is further divided into two subgroups: the first comprises species with denticles lacking any keels and furrows (the smalltooth sawfish Pristis pectinata, the green sawfish Pristis zijsron and the dwarf sawfish Pristis clavata); the second comprises species with denticles presenting keels and furrows well differentiated on their anterior part (the common sawfish Pristis pristis, the largetooth sawfish Pristis perotteti and the greattooth sawfish Pristis microdon). This investigation of the dermal covering provides results which agree with studies that separate the same two species groups of Pristis on the basis of other morphological data.
Trematomus scotti in Beaver Lake: the first record of a fish from a non‐marine Antarctic habitat
Authors: Cromer L. , Williams R. , Gibson J. A. E.
Published: May 2005

The first record of a fish from a non‐marine Antarctic habitat is reported. A specimen of Trematomus scotti(Boulenger) was captured from the brackish water zone of epishelf Beaver Lake (70°7′ S; 68°14′ E).
Retrospective audit of a continuous infusion protocol for haemophilia A at a single haemophilia treatment centre
Authors: Mulcahy R. , Walsh M. , Scully M.‐F.
Published: May 2005

Summary.  Continuous infusion (CI) of factor concentrates has been suggested to decrease the risk of bleeding and reduce cost in the treatment of bleeding disorders. Concerns have also been raised regarding stability and sterility of products administered by CI, the risk of local thrombophlebitis and an association with the development of an inhibitor in mild haemophilia. A retrospective chart review was conducted to investigate a CI protocol regarding product use, maintenance of FVIII levels and the frequency of complications including inhibitor development. Twelve patients with haemophilia A received recombinant factor VIII by CI a total of 18 times between April 1998 and September 2003. Ages ranged from 4 months to 75 years and indications for treatment included severe bleeds and surgical prophylaxis. The protocol which was audited required a bolus of 50 U kg−1 of FVIII followed by CI at an initial rate of 4 U kg−1 hr−1. All infusions were administered by i.v. infusion after diluting the reconstituted concentrate in saline. There were no documented cases of significant bleeding, adverse reactions, thrombophlebitis or infection. Two mild haemophilia A patients developed a low titre inhibitor after receiving CI. It is not clear in either case that CI was the main contributing factor. Our CI protocol will now be modified to use less product, aiming for more cost‐effectiveness.
Rofecoxib as adjunctive therapy for haemophilic arthropathy
Authors: Rattray B. , Nugent D. J. , Young G.
Published: May 2005

Summary.  Joint haemorrhage and subsequent haemophilic arthropathy are significant complications in haemophilia. The pathophysiology involves inflammation and angiogenesis. Cyclooxygenase‐2 (COX‐2) inhibitors are anti‐inflammatory agents, which have potent anti‐inflammatory, anti‐angiogenic and analgesic properties yet do not affect platelet function in the manner of traditional non‐steroidal anti‐inflammatory drugs. These properties make such agents potentially useful as adjunctive therapy in haemophilia. There is only one prior report describing rofecoxib treatment in a single haemophilia patient. Our objectives were to determine the safety and efficacy of rofecoxib in treating acute haemarthrosis, chronic synovitis, target joints and pain. We conducted a retrospective medical record review of patients treated with rofecoxib for acute haemarthrosis, chronic synovitis, target joint or pain. The safety and efficacy of rofecoxib treatment were determined based on subjective patient reports and physical examinations during follow‐up clinic visits. A total of 28 patients between 3 and 37 years of age were treated for a total of 42 courses of rofecoxib treatment. All courses were evaluated for safety and 31 for efficacy. Rofecoxib was used for eight acute haemarthrosis, four target joints, seven cases of synovitis and 12 episodes of pain. Efficacy was demonstrated particularly for chronic synovitis and pain and no serious adverse events occurred. This is the largest study to date evaluating COX‐2 inhibitors as adjunctive therapy in haemophilia and suggests that these agents may be an important adjunctive therapy in the management of haemophilia.
Successful steroid pulse treatment in childhood acquired haemophilia with nephrotic syndrome
Authors: Sakai M. , Shima M. , Shirahata A.
Published: May 2005

Summary.  We encountered a 2‐year‐old boy with acquired haemophilia, which rarely occurs in children, who was complicated with nephrotic syndrome. In mid‐August 2001, he was diagnosed to have nephrotic syndrome based on the presence of massive proteinuria and hypoalbuminaemia. Activated partial thromboplastin time (APTT) was normal at 42.4 s at that time. After starting prednisone administration of 2 mg kg−1 day−1, the proteinuria disappeared immediately. However, in early October the same year, subcutaneous ecchymosis and intramuscular bleeding occurred for no apparent reason, and from the examination results his APTT was 106.4 s, factor VIII (FVIII) activity was <1%, and the anti‐FVIII inhibitor titre was 6.9 BU ml−1. As a result, he was diagnosed to have acquired haemophilia. The anti‐nuclear antibody and anti‐phospholipid antibody were negative. With recombinant activated FVII, haemostasis was obtained, and after administering three courses of steroid pulse therapy (methyl prednisolone: 20 mg kg−1 day−1 × 3 days), the anti‐FVIII inhibitory activity disappeared. An analysis of the immunological and coagulation properties of his FVIII autoantibodies showed the anti‐FVIII inhibitory activity to be mediated by IgG1 antibody. In other words, his FVIII inhibitor was a Th1 dominant and it provided a good response to treatment. These findings correlate with those of previous reports. The patient thereafter frequently demonstrated a recurrence of nephrotic syndrome. As a result, he is presently being managed with cyclosporine. However, no recurrence of the anti‐FVIII titre has been observed.
Handheld computers and paper diaries for documenting the use of factor concentrates used in haemophilia home therapy: a qualitative study
Authors: Arnold E. , Heddle N. , Lane S. , Sek J. , Almonte T. , Walker I.
Published: May 2005

Summary.  A recently published randomized controlled trial (RCT) showed that adherence to infusion diary record keeping was improved by the use of handheld computers. In this study, attitudes to record keeping were explored and patient preferences regarding the method of recording determined for the patients who participated in the trial. Qualitative study consisting of individual semi‐structured interviews with 20 severely affected patients with haemophilia who participated in an RCT. Individuals were purposefully sampled based on their recent method of record keeping and whether child or adult. Analysis employed a constant comparative method to identify key themes from the data. Most individuals (19 of 20, 95%) considered record keeping to be important. They readily identified reasons to keep records: to benefit themselves, their families, clinical staff, product distributors and manufacturers. Keeping records helps them: feel a part of the health care team; have confidence they would be notified of product recalls; review their past history; improve their ability to advocate for themselves and improve communication among all parties. Record keeping, particularly when using paper diaries, can be burdensome and a challenge to maintain consistently. All 10 individuals (100%) who had used both paper diaries and handheld computers preferred the latter. Most patients understand that record keeping can be of benefit to them. Clinics can use this knowledge to inspire other patients by developing educational programmes that de‐emphasize authority. In addition, given the evidence of both patients’ preference for handheld computers, and the effectiveness of this approach documented in an RCT, switching to handheld computers is likely to improve record keeping.
Main clinical manifestations of a bleeding diathesis: an often disregarded aspect of medical and surgical history taking
Authors: Girolami A. , Luzzatto G. , Varvarikis C. , Pellati D. , Sartori R. , Girolami B.
Published: May 2005

Summary.  A suitable clinical evaluation of a bleeding diathesis is often forgone. The young doctor is often unprepared to describe in an accurate way the different types of bleeding. An adequate classification and adequate clinical information about a bleeding diathesis are instead of paramount importance. Bleeding may be cutaneous, mucous, articular, muscular, parenchymal, intracavitary, orificial. Each of these sites and forms may have diagnostic implications. An accurate description of the several forms of cutaneous bleeding (petechiae, purpuric spots, ecchymosis, haematomas, etc.) is needed for referrals and for controls. The correct evaluation of cutaneous bleeding manifestations of children (battered child syndrome) is absolutely important for clinical and medico‐legal purposes. The same is true for the battering syndrome seen in women abused by their spouses. The grading of haemarthrosis in haemophilia patients is important for the follow‐up. A proper description of haematuria is essential in suggesting the probable site of bleeding (kidney or bladder or urethra). A proper evaluation of bleeding may give also useful information on the general health status of the patients (presence of anaemia, poor nutrition, renal insufficiency, etc.). The combination of bleeding and thrombosis in the same patient is also a clinical challenge. The relationship between haemorrhage and thrombosis may be sequential or concomitant. Sequential thrombosis may occur in a patient confined in bed for a brain haemorrhage. Concomitant thrombosis and bleeding occur in DIC and in patients with thrombosis being treated with anticoagulants. Finally, it should be kept in mind that a proper evaluation of the bleeding diathesis of a given patient may help the caring doctor in ordering appropriate laboratory tests (e.g. a platelet count for petechiae, a PTT for a patient with haemarthrosis, etc.).
A comparative analysis of periapical health based on historic and current data
Authors: Chazel J. C. , Tramini P. , Valcarcel J. , Pélissier B.
Published: May 2005

Aim  To compare periapical health using samples from prehistoric and historic periods until the present day, and to emphasize the major risk indicators for apical periodontitis (AP).

Methodology  A comparative survey to assess periapical health was performed on five samples (525 individuals) drawn from different periods of history within the time frame 2000 bc to 2000 ad. Twenty‐one binary risk indicators for AP were retained for a logistic regression model. The probability of a diseased tooth was defined from a two‐level response variable based on the periapical index (PAI). An individual regression model was computed with partial least squares (PLS) regression model, based on the individual mean values of the nine retained risk indicators.

Results  Condensing osteitis, tooth wear, caries, root fillings and the presence of inadequate root fillings were associated with the PAI levels. The maxillary molars and recent time periods (contemporaneous and seventeenth century) were also risk indicators for the pathological condition. The PLS regression for individuals demonstrated correlations between risk factors. This multidimensional analysis indicated that the mean PAI was correlated mainly with caries and condensing osteitis. Condensing osteitis was more frequent in the mandibular than in the maxillary bone (P = 0.001), and correlated with tooth wear in ancient periods.

Conclusions  This comparative analysis demonstrated a significantly higher prevalence of AP in the contemporary period. The most important risk indicators for that period were the presence of inadequate root fillings, carious lesions and condensing osteitis.
The effect of application time of EDTA and NaOCl on intracanal smear layer removal: an SEM analysis
Authors: Teixeira C. S. , Felippe M. C. S. , Felippe W. T.
Published: May 2005

Aim  To verify, under the scanning electron microscope (SEM), the influence of irrigation time with ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) on intracanal smear layer removal.

Methodology  Twenty‐one extracted human permanent teeth with single straight root canals were included. The root canals of the teeth were instrumented and, at the end of preparation, were irrigated with 3 mL of 15% EDTA, followed by 3 mL of 1% NaOCl for 1 min (group 1), for 3 min (group 2), and for 5 min (group 3). The canals of teeth in group 4 (control) did not receive the final irrigation. The teeth were sectioned longitudinally and prepared for an SEM. The dentinal wall of cervical, middle and apical thirds was graded according to the amount of debris and smear layer remaining on the walls. The results were analysed using the Kruskal–Wallis and Conover–Inman tests.

Results  In all the canals of experimental groups irrigation with EDTA and NaOCl completely removed the smear layer from the cervical and middle thirds. In the apical third, the dentine surface were partially covered, particularly in the teeth of group 1, where there was significantly more smear layer when compared with the other thirds in the same group (P < 0.007). However, the Kruskal–Wallis test showed overall that there were no significant differences between groups 1, 2 and 3 (P > 0.05).

Conclusion  In this limited laboratory study, canal irrigation with EDTA and NaOCl for 1, 3 and 5 min were equally effective in removing the smear layer from the canal walls of straight roots.
Periapical resurgery versus periapical surgery: a 5‐year longitudinal comparison
Authors: Gagliani M. M. , Gorni F. G. M. , Strohmenger L.
Published: May 2005

Aim  To monitor and compare the outcome of periradicular surgery in teeth that had previously undergone surgical treatment versus teeth that were undergoing a surgical procedure for the first time.

Methodology  A total of 164 patients with 231 roots with previously unresolved periapical lesions were followed for up to 5 years following surgery. In all, 162 roots had received unsuccessful conventional root canal treatment (group AS) and 69 had been treated previously using apical surgery (group RS). The surgical procedure was completed using ultrasonic retrotips to prepare the apical root‐end cavity, and a zinc‐oxide EBA reinforced material was used to fill the apical root‐end cavities. Lesions were radiologically examined from 1 to 5 years following the surgical procedure. Radiographs were independently analysed, according to a previously published classification.

Results  In all the roots examined after 5 years, the overall healing rate was 78%; in group AS, 140 (86%) healed with complete bone filling of the surgical cavity, 12 (7%) were considered to have incompletely healed and 10 (6%) were associated with post‐treatment disease. In group RS, 41 (59%) healed completely, 12 (17%) were considered to have incompletely healed and 16 (23%) were associated with post‐treatment disease. The difference between a second surgical procedure and a first surgical procedure was statistically significant (Mann–Whitney U‐test, P = 0.001).

Conclusion  Surgical retreatment of teeth previously treated with surgery is a valid alternative to extraction. However, association with post‐treatment disease was greater than after a primary surgical approach.
Unicystic ameloblastoma: a possible pitfall in periapical diagnosis
Authors: Cunha E. M. , Fernandes A. V. , Versiani M. A. , Loyola A. M.
Published: May 2005

Cunha EM, Fernandes AV, Versiani MA, Loyola AM.

Unicystic ameloblastoma: a possible pitfall in periapical diagnosis. International Endodontic Journal, 38, 334–340, 2005.

Aim  To report a clinical case of unicystic ameloblastoma previously misdiagnosed as radicular cyst.

Summary  A 49‐year‐old white male was referred to a private practitioner complaining of an asymptomatic bony hard swelling of the left posterior mandible. The patient's dental history indicated that his left mandibular first molar had been extracted approximately 10 years previously. At that time, preoperative radiographic examination demonstrated a radiolucent area of 1.5 cm diameter with well‐defined margins involving the distal root of tooth 36. The lesion was diagnosed as cystic and surgery for its removal was advised, but not performed. At presentation, radiography demonstrated a well‐defined 3 cm diameter radiolucency extending from the second premolar to the second molar. The lesion was enucleated and histopathological examination confirmed a diagnosis of unicystic ameloblastoma.

Key learning points •Despite a clinical diagnosis of periapical disease of endodontic origin, a nonendodontic lesion may be present.

•Unicystic ameloblastoma located on the periapical area of a tooth can lead to a pulp‐periapical misdiagnosis, and should be considered in differential diagnosis.

•All tissue specimens recovered in apical surgery should be submitted to histopathological analysis.