bluuebunny/crossref_metadata_2025 huggingface dataset:
An experimental study on friction welding of medium carbon and austenitic stainless steel components
Authors: Sahin Mümin , Erol Akata H.
Published: March 2004

In the presented study, AISI 1040 medium carbon steel and AISI 304 austenitic stainless steel parts were joined by friction welding. The welding process was carried out under optimized conditions using statistical approach. Tension tests were applied to welded parts to obtain the strength of the joints. Fatigue properties were additionally obtained experimentally under fluctuated tensile loads. Finally, notch impact tests were applied to the joints. Microstructures using microphotographs were examined in the heat affected zone of welded parts. Hardness variations in welding zone were also obtained. Experimental results were compared with those of previous studies.
Crossroads, traffic‐lights or roundabouts? Collaboration now and in the future of New Zealand’s tertiary education libraries
Authors: Pharo Sue
Published: March 2004

The last three years have brought major changes to New Zealand’s tertiary education libraries. Case studies of four examples of New Zealand collaboration demonstrate this. At the time of writing, these consortia have arrived at another crossroads with the announcement of competitive government funding, the first time ever that New Zealand libraries have had an opportunity to bid in this way. Issues facing the consortia include the sometimes overlooked leadership and group dynamics as well as the formalities of governance, funding and project management.
Marketing of library services: a case study of selected university libraries in Kenya
Authors: Muema Kavulya Joseph
Published: March 2004

Regardless of the type, libraries are under pressure to justify their existence and funding through provision of customer‐ or market‐oriented services. This requires a shift from product or service orientation to customer or need orientation. Different marketing concepts provide libraries with the tools for collecting and analysing useful data about information needs of customers, which assists in designing, developing and delivering appropriate services. This paper examines the methods used by university libraries in Kenya to market their services to different categories of users and the problems experienced therein. It concludes that, although efforts have been made to achieve this, more emphasis must be put on promotion of the already existing services and therefore on the need for university libraries in Kenya to adapt more systematic techniques in collecting data on their user needs, if they are to design and deliver services that fit user requirements.
Siting of public libraries in retail centres: benefits and effects
Authors: Morris Anne , Brown Anna
Published: March 2004

This paper explores the potential benefits of siting public libraries within retail developments. Evidence is based on a literature review and five case studies in the UK that involved interviews with librarians, shopping centre managers and shop managers. The greatest benefit of the presence of a public library in retail centres is increased footfall. Shopping centre locations also benefit the library, and this is often perceived as being more significant than the library’s impact on the shops. Recommendations are made as to how libraries could maximise the awareness of their value and the benefits they provide.
LIS labour market research: implications for management development
Authors: Cullen John
Published: March 2004

Research findings on the recruitment market for library and information service (LIS) workers are discussed in the context of management development. Qualitative and quantitative analysis of the results uncovered implications for organisations and individuals seeking to develop management and leadership capabilities amongst managers of library and information services. Recruitment advertising seems to solicit applications for management positions on the grounds of evidence of professional development rather than evidence of management development. The implications of professional and management cultures for library management and leadership development are discussed. Further research questions on management development in a library setting are proposed.
Management musings 16: must good theory be defeated by external pressures?
Authors: Line Maurice B.
Published: March 2004

Lists the main themes of management theory and outlines how management practice can be very different. Notes that the reduction in job security and the increasing use of performance measures and targets should not mean a return to old and discredited ways of managing and working.
Continuing professional development and workplace learning 7: human resource development – a tool for achieving organisational change
Authors: Smith Ian
Published: March 2004

Discusses the “people” aspect of organisational change and the ways in which human resource development (HRD) can act as an effective organisational change tool. Outlines a six‐step best‐practice model for the application of HRD in achieving organisational change.
Finding that document! Enhancing the discovery and locating of journals
Authors: Awre Chris
Published: March 2004

In order to address the problem of discovering and accessing relevant documents in the ever‐increasing amount of information presented to us, the Joint Information Systems Committee (JISC) has funded a series of projects to address the chain of information access: discover, locate, request, deliver. This article reviews the work and results of these JOIN‐UP projects and places them in the wider context of document delivery, the use of open standards to achieve interoperability between systems, and the overall information environment that users interact with. In addition, initial progress on the development of a national serials union catalogue, SUNCAT, is reported, to assist with national discovery of journal titles.
The bibliographic advantages of a centralised union catalogue for ILL and resource sharing
Authors: Hider Philip
Published: March 2004

Examines some of the bibliographic advantages of a union catalogue with a central database over a distributed, or “virtual” union catalogue. Discusses the nature of these bibliographic advantages in the context of interlibrary document delivery, and also the circumstances which produce them, and make them more significant. Reports on a brief study of the extent to which two major library catalogues in Singapore have diverged following the adoption of a distributed model. This indicated that the bibliographic content of a distributed union catalogue may be significantly poorer than that of a central database, and in particular in terms of more: duplication; inconsistency; errors; and omissions. There are at least four important reasons why this may be so.
Linking four libraries 9,012km apart: steps to global resource sharing
Authors: Leon Lars E.
Published: March 2004

Understanding challenges like restrictive licenses, fees to recover costs that price information out of reach of some patrons, and high shipping costs help libraries provide focus on what needs to be researched to make improvements. Successful tools to facilitate resource sharing such as the power of groups, ability to easily discover holdings and transmit interlibrary loan requests in efficient methods using standards all contribute to improved resource sharing. This should eventually help improve resource sharing for libraries in Kansas and in Bulgaria even if they do not necessarily need to exchange information to meet the needs of their local patrons.
Times of change for document delivery: a view from Infotrieve
Authors: Labriga Petra
Published: March 2004

The development of Infotrieve as a commercial and global document supplier is described. Change in the market place is assessed and new developments described.
Interlibrary lending and document supply: past, present and future
Authors: Mark Niels , Knakkergaard Lone
Published: March 2004

The authors give an overview of remote document supply in the world today and some of the key factors influencing its development. They illustrate this by referring to the Ghana project – a collaborative project between Danish and Ghanaian libraries to facilitate document supply, funded by IFLA. Finally, they make some predictions for the future.
Transitions – news on the access to digital information in France
Authors: Schöpfel Joachim
Published: March 2004

The author describes the present document delivery situation in France with particular reference to copyright and the EU Directive, consortia, portals, funding and some suggestions for the future.
Interlending and document supply: a review of recent literature – XLVIII
Authors: McGrath Mike
Published: March 2004

Reviews more than 100 journals and some electronic lists and newsletters for issues relevant to interlending and document supply. In particular, focuses on site licences, providers of document supply, pricing, copyright, usage and open access.
Effects of conductor surface condition on signal integrity
Authors: Bayes Martin , Horn Al
Published: March 2004

The evolution of digital electronic systems to ever‐faster pulse rise times has placed increased demands on printed wiring board (PWB) materials. Signal loss associated with dielectric materials has driven development and commercialization of cost‐effective low loss laminate materials. In order to provide a better understanding of conductor material and surface finish choices, efforts have been made to quantify the impacts of these factors on loss. An alternative test approach has been identified which provides a measure of conductor performance, decoupled from both system geometry and the influence of laminate material.
Modified mixed metal oxide coated anodes for reduced additive consumption in base metal plating baths
Authors: Menard S. , Wurm J.
Published: March 2004

Insoluble and therefore oxygen developing anodes tend to destroy additives in plating baths. With a modified mixed metal oxide coated anode, it is possible to reduce the consumption of additives in copper electrolytes and to reduce the formation of Sn4+ in acid tin electrolytes. Favourable applications for this new anode type are under discussion.
A new phase for vapour‐phase – an overview of the current status of vapour phase technology for soldering and related applications
Authors: Wood Russ
Published: March 2004

This paper focuses on the renewed interest in the use of condensation, or vapour‐phase, soldering in lead‐free surface mount assembly soldering and notes also the corresponding legislation, which will preclude the use of lead‐based solders in most applications by 2006. The process is once again becoming popular, because of the absolute control of soldering temperature, and because high‐quality batch and in‐line equipment is now available. It notes that condensation heating with perfluorocarbon liquids and present well‐designed equipment can be used not only in the mass‐assembly of electronic circuit boards, but also for a large variety of other heating tasks in many industries.
Micro via filling plating technology for IC substrate applications
Authors: Yeh Cheng‐Ching , Lan Kuo‐Hsing , Dow Wei‐Ping , Hsu Jui‐Hsia , Lee Cliff , Hsu Chih‐Hao , Lee Ken , Chen Jordan , Lu Philip
Published: March 2004

The trend of electronic products toward lighter, thinner, and faster transmission is challenging the printed circuit board industry to incorporate high density interconnection technology (such as build‐up and semi‐additive processes). Micro stacked via is one technology utilized to produce high‐density structures. Dielectric resin, conductive paste or via plating are usually applied for the filling process. As compared with other filling methods, via filling plating technology has advantages in offering a shorter process and higher reliability. This paper discusses the influence of different equipment design, operating conditions and additives on via filling plating technology.
A novel copper electroplating formula for laser‐drilled micro via and through hole filling
Authors: Dow Wei‐Ping , Chen Hsiang‐Hao
Published: March 2004

Printed circut boards (PCBs) have diminished in size and, simultaneously, their circuit densities have increased. Conventional multi‐layered PCBs have a limitation to higher packaging densities. This paper introduces a new copper electroplating formula that is able to fill vias and through holes simultaneously and is used in a DC plating method, in which the copper thickness deposited on the board surface is relatively very thin after the electroplating is completed.
Development of an electroless nickel immersion gold process for PCB final finishes
Authors: Kwok R.W.M. , Chan K.C.M. , Bayes M.W.
Published: March 2004

A new generation of electroless nickel immersion gold process has been developed that is targeted to solve the “Black Nickel issue”. The development involved the understanding of the details of the nanostructure of electroless nickel, the interface between Ni and Au, Ni and solder, and the control of the porosity of the Au surface. A suitable increase in phosphorous content in the nickel deposit reduces the hyperactive corrosion during immersion gold process. In addition, a stabilizer system that gives consistent performance across the entire bath life was used to improve the simplicity of bath control. This combination gives many advantages for the applications in printed wiring boards.
UK PCB Industry 1997 to 2003
Authors: Reed Fiona M. , Patrick Webb D. , Walsh Kathryn , Carpineta Paride
Published: March 2004

This paper presents a snapshot of the status of the UK printed circuit board (PCB) industry in 2003. Comparisons are made with a similar study from 1997. Data are presented concerning employment and turnover within the industry, the number of manufacturing sites engaged in PCB manufacture and assembly, and the geographical location of these sites. Employment in PCB manufacture is found to have dropped by more than half, and there has also been a general shift from large firms with over 250 employees to medium‐sized firms with between 50 and 249 employees.
Sustainable technologies for the regeneration of acidic tin stripping solutions used in PCB fabrication
Authors: Kerr Charlie
Published: March 2004

Electroplated tin deposits are used as etch resists during the processing of printed circuit boards. The tin coating protects the copper tracks during etching but is subsequently removed (stripped) to expose the defined copper circuitry. The commonly used stripping solutions are based on nitric acid and after use they represent a very acidic waste product with a high metal content. The disposal of these spent strippers is typically via off‐site neutralisation and precipitation followed by subsequent landfill. This is clearly a non‐sustainable waste of valuable resources and a practice that is increasingly undesirable as environmental legislation becomes more stringent. This paper outlines the results of a scoping study carried out into current industry practices for tin stripping and details of components of a potential integrated treatment system for these stripping solutions. Individual technologies for such an integrated system incorporate the recovery of the tin oxide by filtration, the concentration and reuse of nitric acid solutions by diffusion dialysis and the reclamation of other metals, i.e. copper by electrowinning.
Prospects for continuing professional education for library and information science professionals in Nigeria: the case of Delta State
Authors: Adomi Esharenana E. , Nwalo Kenneth I.N.
Published: March 2004

This paper surveys the prospects for continuing professional education (CPE) of library and information science (LIS) professionals in Nigeria using Delta State as a case study. Questionnaire and interview techniques were used to gather data. A total of 51 practitioners made up of professionals and paraprofessionals from academic, public, special libraries and information centres were used in the study. Conclusions based on findings recommend that LIS organisations should be more committed to the CPE of their staff; that practitioners should commit their personal funds to their CPE if their organisations fail to support them and that the professional association (Nigerian Library Association) should develop clear cut programmes for the development of practitioners.
Organisational value of participating in a quality award process: a Swedish study
Authors: Eriksson Henrik
Published: March 2004

One way for organisations to support total quality management, and hence try to increase customer satisfaction is to participate in a quality award process. The purpose of this study is to explore the organisational value of participating in a quality award process. The study is based on interviews at 29 organisations that have participated in the process of the Swedish Quality Award. The main conclusion is that most of the organisations consider the process orientation, customer orientation and improvement work to have been improved as a result of the participation in the quality award process. However, there are also obstacles to surmount in order to benefit fully from the process: difficulties in finding resources within the organisation to perform mandatory work and implement identified improvements, and difficulties in applying the circumstantial model used in the quality award process.
Total quality system as a product of the empowered corporate culture
Authors: Ambroz˘ Milan , Ambroz˘ Milan , Ambroz˘ Milan
Published: March 2004

The ever‐changing global environment that is more and more quality driven demands a new vision of the role of corporate culture in the implementation of total quality in a manufacturing company. This study of three manufacturing companies in Slovenia shows that only an open and human oriented corporate culture that is based on the autonomy of the workplace and human resource management can be successful in implementing the total quality management (TQM) in all working processes in the company. Employees are empowered and intrinsically motivated for quality work when they have internal justification for taking actions that are supported by corporate culture. They definitely play an active role in the TQM environment.
Process reengineering: who embraces it and why?
Authors: Burke Ronald J.
Published: March 2004

This study examined employee reactions to a process reengineering initiative in a large financial services organization. Data were obtained from 2,514 employees, using questionnaires completed anonymously. Employees having longer company tenure, those at higher levels, and men held more favorable attitudes toward the reengineering initiative. Employees indicating greater understanding of the reengineering effort had more favorable attitudes toward it. Employees holding more favorable attitudes toward the process reengineering initiative also reported more positive work experiences and outcomes and described the organization in more favorable ways. Implications for managing large‐scale change efforts are proposed.
National quality and business excellence awards in a developing country: the Fiji National Quality Award
Authors: Djerdjouri Mohamed
Published: March 2004

In this paper, the essence of the Fiji Quality Awards (FQA) is presented. The history, framework, principles, objectives, examination criteria and the award process of the national quality awards will be thoroughly described. Further, a list of all FQA recipients, since its inception, will be provided.
HR utilization and quality improvement: the reality and the rhetoric – the case of Greek industry
Authors: Vouzas Fotis
Published: March 2004

It is argued that quality improvement efforts play an important role in industrial organizations by altering the role of the human resource management (HRM) function and the human resource professional as TQM is consistent with a move towards a more strategic HRM approach. Investigates and empirically tests the current status of the quality improvement efforts in selected industrial organizations in Greece and analyzes the “HR elements” related to these efforts. Also examines the extent to which Greek industrial organizations differentiate in the way they utilise their human resources as well as in the influence their human resource/personnel departments enjoy. The main findings of the study were that HR function in Greek industrial organizations has been seriously neglected for years and the role of the personnel professionals in quality improvement efforts has been overlooked.
Total quality plan applied in the Hellenic power production process
Authors: Papachristos D. , Tsoukalas V. , Vlachogiannis J.
Published: March 2004

The use of a designed quality plan for application in the electrical power industry is presented. Some contributions of Taguchi’s technique in power process parameter design are reviewed. Recommendations are made for developing a quality‐training plan that will incorporate the design of experiments and description of training sources. A case study of the experiment design in the Hellenic power production process is discussed. Difficulties with design of experiments applications to the power process are outlined and suggestions are offered for resolving these difficulties.
Conceptualizing total quality management in higher education
Authors: Sahney Sangeeta , Banwet D.K. , Karunes S.
Published: March 2004

In keeping with the socio‐economic and cultural transformation that has placed newer demands on the educational system, in terms of greater responsibility and accountability and increased expectations by stakeholders, the system has been pressurized to shift its focus from one in quantitative expansion to one with emphasis on quality. Such shifts and changes are being witnessed not only in the developed countries, but also in the developing countries of the world. The education system, and more so the higher education system in particular, in an attempt to react to the demands and ever increasing pressures from its stakeholders, finds itself in a market‐oriented environment, with internal and external customers; wherein, “delighting the customer”, is the rule for survival in the long run. “Delighting the customer”, is the core message of total quality management (TQM) and, hence, there is a need to identify and apply the relevant concepts of TQM to each and every aspect of academic life; that is, to the teaching, learning and administrative activities. The paper is a theoretical attempt at conceptualizing TQM in education.
US and German activity‐based costing
Authors: Willi Kellermanns Franz , Islam Majidul
Published: March 2004

Activity‐based costing is widely used in managerial accounting as a cost measurement instrument. Accounting practices can differ widely between countries. Recognizing differences and similarities in seemingly identical practices between countries provides the opportunity for improvement and allows us to draw managerial implications in light of the increasing internationalization of companies. This paper compares US and German activity‐based costing. The paper establishes differences based on purpose, cost concepts, construction and cost allocation, and quantity and quality of cost information. It then proceeds by using the Technology Acceptance Model (TAM) to formulate propositions concerning the acceptability of the systems by managerial accountants in the USA and Germany.
Benchmarking JIT
Authors: Yasin Mahmoud M. , Wafa Marwan , Small Michael H.
Published: March 2004

Investigates several facets of the implementation of just‐in‐time (JIT) using a two‐tiered empirical approach that included a field study and a mailed survey. The 277 respondents to the survey included 130 manufacturing organizations, 61 service organizations and 86 public sector organizations in the USA. Five hypotheses were tested. The results indicate that while all the organization types had enacted procedural and operational modifications in support of their JIT implementations, there were some differences in the impact that these modifications had in reducing problems during the implementation and on the eventual outcome of the project. Suggests areas where benchmarking can be utilized by the various organization types to alleviate potential problems in the JIT implementation process and to improve their chances of success.
KPIs: a critical appraisal of their use in construction
Authors: Beatham Simon , Anumba Chimay , Thorpe Tony , Hedges Ian
Published: March 2004

Traditionally businesses have measured their performance solely in financial terms. This limited approach has been challenged, with the introduction of the concept of key performance indicators (KPIs) for non‐financial results. In response to the Latham and Egan Reports, the UK construction industry has developed its own set of KPIs. However, their effective use has been limited. This paper reviews these and other construction KPIs and concludes that most of the KPIs used are post event, lagging measures that do not provide the opportunity to change. Their results are not validated and thus are open to interpretation. The result is that KPIs are being used within the industry as a marketing tool, and not as an integral part of business management. This paper distinguishes between three types of measure and suggests a framework for their effective use within an overall performance measurement system based on change action driven by results.
A New Specification of Labour Supply in the MONASH Model with an Illustrative Application
Authors: Dixon Peter B. , Rimmer Maureen T.
Published: March 2004

MONASH is a dynamic general equilibrium model of the Australian economy. This article describes a new labour‐market specification for MONASH in which people are allocated in year t to categories according to their labourmarket activities in year t – 1. People in each category plan their labour supplies by solving an optimisation problem. Via these problems, we introduce the assumption that people in employment categories supply labour more strongly to employment activities than do people in unemployment categories. Thus we find that employment‐stimulating policies in t – 1 increase labour supply in t by shifting the composition of the labour force in t in favour of employment categories and away from unemployment categories. We illustrate this idea by using MONASH to simulate the Dawkins proposal to combine a freeze on award wage rates with tax credits for low‐wage workers in low‐income families. We find that the Dawkins policy would generate a significant short‐run increase in employment. With the increase in employment generating an increase in labour supply, the employment benefits of the policy would persist over many years. However, in the long run, we would expect the effect of the policy on aggregate employment to be small and to depend on how the policy affected the ratio of real after‐tax wage rates to unemployment benefits.
Bundling in the Australian Telecommunications Industry
Authors: Papandrea Franco , Stoeckl Natalie , Daly Anne
Published: March 2004

This article considers some of the implications for social welfare of bundling in the Australian telecommunications industry. The practice of bundling—offering two or more products for sale as a single package—is a strategy used in many industries. Although common, there are circumstances when the practice can be used anti‐competitively. Yet bundling does not always harm consumers; at times, the practice benefits both consumers and producers, and it can even advantage consumers to the detriment of producers. The general literature on bundling suggests that its effect on social welfare depends on several factors such as market structure, the elasticity of demand for the products, the marginal cost of production, economies of distribution and the use of complex menus. We consider these factors when assessing the likely welfare effects of bundling in the Australian telecommunications industry, concluding that the potential effects of bundling on competition and the information costs imposed on consumers by complex menus of services seem the most significant considerations for social welfare. It is desirable that regulatory authorities monitor developments closely, although heavy‐handed regulation of bundling seems undesirable.
Choice of School in Australia: Determinants and Consequences
Authors: Le Anh T. , Miller Paul W.
Published: March 2004

This article examines the determinants of school choice (government, Catholic or other independent schools) as well as the success in completing year 12 for cohorts of students born in 1961 and 1970. The results show that those attending Catholic and other independent schools have favourable socio‐economic backgrounds. Ability has a significant and positive effect on the probability of completing year 12. There is no evidence of unobserved selection effects on the probability of completing year 12 for the 1961 cohort. For the 1970 cohort, there is negative selection into other independent schools and positive selection into Catholic schools. Decomposition results further reveal that selection on the basis of observed characteristics accounts for only a small part of the observed differences in year 12 completion rates across the three school systems. In comparison, selection on the basis of unobserved factors is an important part of the difference in year 12 completion rates. The school effects for both cohorts are much larger than those reported in previous studies.
Twin–twin transfusion syndrome treated with serial amniocenteses
Authors: Johnsen Synnøve Lian , Albrechtsen Susanne , Pirhonen Jouko
Published: March 2004

Background.  To evaluate the treatment and neonatal outcome in pregnancies complicated by twin–twin transfusion syndrome (TTS).

Material and methods.  Twenty‐four women with TTS were identified in the period 1993–99 among 34 477 deliveries. We include a retrospective chart review of all twins with TTS.

Results.  The overall incidence of TTS was 4.75% of all twin pregnancies. The mean gestational age at the time of diagnosing TTS was 23 weeks (range 17.6–38), and the mean gestational age at delivery was 34.6 weeks (range 23.1–38.3). Therapeutic amniocenteses was performed in 21 women. The total volume drained varied from 0.4 to 32.31 with a mean of 2.3 l. Overall perinatal mortality in TTS was 35.4%, as nine donor twins and eight recipient twins died. The main causes for mortality were intrauterine death and prematurity.

Conclusion.  Twin–twin transfusion syndrome is a severe complication in monochorionic diamniotic twin pregnancies, with high perinatal mortality and morbidity even though amnioreduction prolonged the pregnancies leading to better neonatal outcome.
Higher activity by opaque endometriotic lesions than nonopaque lesions
Authors: Khan Khaleque Newaz , Masuzaki Hideaki , Fujishita Akira , Kitajima Michio , Sekine Ichiro , Ishimaru Tadayuki
Published: March 2004

Background.  Higher activity by early endometriosis than advanced endometriosis has been reported. However, the pattern of activity in individual colored endometriotic lesions in pelvic cavity is unknown. We investigated the variation in activity of the different colored morphologic lesions as proposed by the current revised American Society of Reproductive Medicine (ASRM) classification in women with endometriosis.

Methods.  Peritoneal fluid (PF) and biopsies were collected during laparoscopy from 45 infertile women with pelvic endometriosis and 15 women without endometriosis. PF concentrations of hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), interleukin‐6 (IL‐6) and monocyte chemotactic protein‐1 (MCP‐1) were measured by enzyme‐linked immunosorbent assay (ELISA). The immunohistochemical staining of HGF and proliferating cell nuclear antigen (PCNA) in opaque and nonopaque endometriotic lesions was examined using respective antibodies, and a computer‐analyzed modified quantitative‐histogram score (Q‐H score) was used to quantify the immunoreaction.

Results.  Opaque red lesions were defined as nontransparent lesions, including polypoid excrescence, blood bleb or ecchymosis, and nonopaque lesions were defined as translucent or transparent lesions, including vesicular bleb or clear papule. The women with endometriosis containing dominant opaque red lesions showed significantly higher PF concentrations of HGF, VEGF, IL‐6 or MCP‐1 than those with either nonopaque lesions or black lesions or control women. There was no difference in any of these cytokine or chemokine levels between women harboring nonopaque lesions and black lesions. Interestingly, PF concentrations of all these markers were significantly reduced in women containing true black lesions and true white lesions after excluding the presence of coexisting red spot from dominant black or white lesions. In a parallel fashion, the immunoexpressions of HGF and PCNA in intact tissue as shown by the Q‐H score were significantly stronger in the opaque red lesions than in the nonopaque lesions or black lesions.

Conclusions.  Opaque red lesions display a higher activity than with nonopaque red lesions in both PF and intact tissue. This indicates different histogenesis in their generation in the pelvic cavity.
Markedly elevated levels of inflammatory cytokines in maternal serum and peritoneal washing during arrested labor
Authors: Abramov Yoram , Ezra Yossef , Elchalal Uriel , Ben‐Shachar Inbar , Fasouliotis Sozos J. , Barak Vivian
Published: March 2004

Background.  The role of inflammatory cytokines in the pathophysiology of arrested labor is currently unknown. We measured levels of inflammatory cytokines in maternal serum and peritoneal washings in arrested first stage of labor to assess the possible involvement of these mediators in this obstetric disorder.

Methods.  This was a prospective, case–control study involving 15 women who underwent cesarean section for arrested cervical dilatation (group I), 15 controls who were operated during active labor for nonreassuring fetal heart‐rate tracing (group II) and 15 controls who were operated electively (group III). Blood samples were drawn from all women shortly before the operation. The presence of peritoneal fluid was assessed and peritoneal washings were obtained during the operation. All samples were assayed for the inflammatory cytokines interleukin (IL)‐1β, IL‐6, IL‐8 and soluble IL‐2 receptor (sIL‐2R) by solid‐phase enzyme‐linked immunosorbent assay (ELISA).

Results.  All women from group I and one patient (6.7%) from group II had some degree of peritoneal fluid accumulation, while none from group III had any. Serum samples from group I contained significantly higher IL‐1β, IL‐6, IL‐8 and IL‐2R levels than both control groups. Peritoneal washings from group I contained significantly higher IL‐1β, IL‐6 and IL‐8 but similar IL‐2R levels.

Conclusions.  Arrested first stage of labor is associated with peritoneal fluid accumulation and increased levels of inflammatory cytokines in both serum and peritoneal fluids. Inflammatory cytokines may therefore be involved in the pathophysiology of arrested labor.
Subarachnoid hemorrhage due to cerebral aneurysmal rupture during pregnancy
Authors: Roman Horatiu , Descargues Gérome , Lopes Manuel , Emery Evelyne , Clavier Erick , Diguet Alain , Freger Pierre , Marpeau Loïc , Proust François
Published: March 2004

Cerebral aneurysmal complications rarely occur during pregnancy. Telling the difference between eclampsia and cerebral hemorrhage due to aneurysmal rupture can prove to be difficult. Aneurysmal management should be performed in an emergency but fetal prognosis should be considered. We report a series of eight pregnant women presenting aneurysmal complications and we have assessed their management and outcome. Both maternal and perinatal mortality rates were correlated with the maternal clinical score. We stress the role of combined care by both neurosurgeons and obstetricians. An emergency cesarean section followed by aneurysmal treatment appears to be a widely accepted strategy in pregnant women with cerebral aneurysmal complications.
Cancer risk after hospital discharge diagnosis of benign ovarian cysts and endometriosis
Authors: Borgfeldt Christer , Andolf Ellika
Published: March 2004

Background.  The aim was to evaluate whether patients with benign ovarian cysts, functional ovarian cysts, or endometriosis have an increased risk of developing gynecologic cancer.

Methods.  The Swedish Hospital Discharge Register was used to identify a cohort of women discharged from hospital with the diagnoses of ovarian cyst (n = 42 217), functional ovarian cyst (n = 17 998), or endometriosis (n = 28 163). To each case, three controls were matched. The National Swedish Cancer Register matched all incident cancers diagnosed among cases and controls. From the Fertility Register, the date of birth of children born to the cases and controls were obtained.

Results.  Women with endometriosis had an increased risk for ovarian cancer (OR 1.34; 95% CI 1.03–1.75), but no association was found between ovarian cysts or functional cysts and ovarian malignancy, including all ages. Young women (15–29 years old) discharged from hospital for ovarian cysts and functional cysts showed an increased risk of developing ovarian cancer later in life (OR 2.2; 95% CI 1.3–3.9 and OR 1.8; 95% CI 1.5–2.0), as well as women with ovarian cysts who had undergone ovarian cyst resection or unilateral oophorectomy (OR 8.8; 95% CI 5.2–15). The risk of developing ovarian cancer was inversely related to parity. Mean age at diagnosis was significantly lower in all three study groups.

Conclusion.  In this study women with endometriosis and young women who had undergone surgery with removal of an ovarian cyst had an increased risk of developing ovarian cancer.
Mild gestational hyperglycemia, the metabolic syndrome and adverse neonatal outcomes
Authors: Bo Simona , Menato Guido , Gallo Marie‐Laure , Bardelli Chiara , Lezo Antonela , Signorile Anna , Gambino Roberto , Cassader Maurizio , Massobrio Marco , Pagano Gianfranco
Published: March 2004

Background.  The aim of this study was to evaluate the prevalence of the metabolic syndrome and its effect on neonatal outcomes in pregnancies with different degrees of hyperglycemia.

Methods.  One hundred and fifty women with gestational diabetes, 100 with one abnormal value on the oral glucose tolerance test, 100 with a normal oral glucose challenge test and 350 with an abnormal challenge test and normal tolerance test were enrolled.

Results.  The prevalence of the metabolic syndrome was: 0%, 4.9%, 20% and 18% in the normal challenge test, abnormal challenge and normal tolerance test, one abnormal value and gestational diabetes patients, respectively. Offspring birth weights, prevalence of large‐for‐gestational age babies and icterus were significantly higher in women with an abnormal challenge test (both with a normal tolerance test or one abnormal value or gestational diabetes). Metabolic syndrome was the best predictor of the presence of large‐for‐gestational age babies in patients with an abnormal challenge and normal tolerance test (OR = 3.15), one abnormal value (OR = 3.53) and gestational diabetes (OR = 4.15).

Conclusions.  Metabolic syndrome in mid‐pregnancy was an independent predictor of macrosomia in women with any degree of gestational hyperglycemia; the oral glucose challenge test identifies pregnancies with metabolic abnormalities and adverse neonatal outcomes also in the presence of a normal oral glucose tolerance test.
Episiotomy and perineal tears presumed to be imminent: randomized controlled trial
Authors: Dannecker Christian , Hillemanns Peter , Strauss Alexander , Hasbargen Uwe , Hepp Hermann , Anthuber Christoph
Published: March 2004

Background.  The indication of the restricted use of episiotomy at tears presumed to be imminent is not clear.

Methods.  Randomized controlled trial with two perineal management policies. Use of episiotomy: (a) only for fetal indications and (b) in addition at a tear presumed to be imminent. Participants: 146 primiparous women with an uncomplicated singleton pregnancy at >34 weeks of gestation. For the intention‐to‐treat analysis those 109 women were included who vaginally delivered a live full‐term baby between January 1999 and September 2000: 49 women in group a, 60 in group b.

Outcome measures.  Reduction of episiotomies, increase of intact perinea or only minor perineal trauma (intact perineum and first‐degree tears), third‐degree tears, anterior perineal trauma, perineal pain in the postpartum period, pH of the umbilical artery, Apgar scores, maternal blood loss.

Results.  Episiotomy rates were 41% in group a and 77% in group b (p < 0.001). Women in the restrictive policy group had a greater chance of an intact perineum (29% vs. 10%; p = 0.023) or only minor perineal trauma (39% vs. 13%; p = 0.003) and had significant lower pain scores postpartum at different activities. There were no statistically significant differences with regard to third‐degree tears, anterior trauma, pre‐ and postpartum hemoglobin concentrations, Apgar scores and pH of the umbilical artery.

Conclusions.  Avoiding episiotomy at tears presumed to be imminent increases the rate of intact perinea and the rate of only minor perineal trauma, reduces postpartum perineal pain and does not have any adverse effects on maternal or fetal morbidity.
Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study
Authors: Uustal Fornell Eva , Wingren Gun , KjØlhede Preben
Published: March 2004

Objective.  To describe a general population of women with regard to factors associated with urinary and fecal incontinence and genital prolapse symptoms.

Methods.  A questionnaire about medical background, urinary and fecal incontinence and genital prolapse symptoms was mailed to 1000 40‐year‐old and 1000 60‐year‐old Swedish women. Associations were described by odds ratios (ORs) with 95% confidence intervals (CIs).

Results.  Sixty‐seven percent answered the questionnaire. Multivariate analysis showed urinary incontinence to be associated with anal sphincter rupture [OR 4.4 (95%  CI 1.0–18.8)], pelvic heaviness [3.8 (2.1–7.0)], body mass index (BMI) ≥30 kg/m2[3.7 (2.0–6.7)], multiparity [1.8 (1.0–3.4)], varicose veins surgery [1.9 (1.2–3.2)] and age [1.9 (1.2–3.2)]. Univariate analyses revealed statistically significant associations between urinary incontinence and incontinence for flatus [4.8 (3.0–7.8)], for liquid stool [5.0 (2.9–8.6)] and for solid stool [5.9 (2.4–14.2)]. Chronic bronchitis [5.7 (1.7–18.9)] was strongly associated with urinary incontinence but was only reported by the older age group. Prolapse symptoms were strongly associated with both urinary and fecal incontinence. Prolapse symptoms as opposed to urinary and fecal incontinence seemed to be associated more with injuries at delivery than with chronic pelvic floor strain.

Conclusions.  Women with urinary incontinence are also likely to suffer from fecal incontinence and prolapse and vice versa. Other associated factors for pelvic floor dysfunction were overweight, and especially obesity, chronic bronchitis, vaginal delivery and multiparity, age, heredity and diseases suggestive of collagen disorders. A multidisciplinary management of women with pelvic floor symptoms is suggested and possible prevention is discussed.
Role of routine ultrasonography in monitoring the outcome of medical abortion in a clinical setting
Authors: Acharya Ganesh , Haugen Michael , Bråthen Anders , Nilsen Ingard , Maltau Jan Martin
Published: March 2004

Background.  Clinical methods generally used to evaluate the completeness of medical abortion are not accurate. There are no published reports evaluating the role of routine ultrasonography in monitoring the outcome of medical abortion. The purpose of this study was to investigate whether routine transvaginal ultrasonography (TVS) at the follow‐up visit after medical abortion can accurately identify women who will require surgical intervention.

Design.  Retrospective review of medical records and charts of all women undergoing medical abortion in the first trimester of pregnancy between January 1999 and December 2001.

Methods.  Medical abortion was performed using oral mifepristone and a vaginal prostaglandin analog before 63 days gestation. All women had an initial TVS to confirm intrauterine pregnancy and gestational age, and another TVS at the follow‐up visit 2–3 weeks later to assess the completeness of abortion. Surgical evacuation of the uterus was allowed as indicated on clinical grounds but not on the basis of ultrasound findings only.

Results.  A total of 690 women consented to medical abortion during the study period. Eleven of these women were excluded from the study for various reasons. Of the remaining 679 cases, 95% (645/679) had a documented follow‐up at the hospital. The pregnancy termination rate among these women was 99.2% (640/645) and TVS identified all five cases of continuing pregnancy at the follow‐up. A total of 66 (10.2%) patients had complications. The uterine cavity was empty on TVS at the follow‐up visit in 84.8% (547/645) of cases and only 3.1% (17/547) of them required surgical aspiration/curettage due to excessive or prolonged vaginal bleeding. In the remaining 15.2% (98/645) the uterine cavity was not empty, and 43.9% (43/98) of them had a curettage. The risk of requiring a surgical intervention was significantly higher [odds ratio (OR) 24.4; 95% confidence interval (95% CI) 14.9–39.7] when the uterine cavity was not demonstrated to be empty at the follow‐up visit 2–3 weeks after medical abortion. However, 59.1% (55/93) of women did not require surgical intervention despite ultrasound evidence of thick endometrial echo‐complex.

Conclusion.  Routine TVS 2–3 weeks after medical abortion appears to be an efficient means of accurately identifying the cases of ongoing pregnancy and diagnosing a complete abortion. Although TVS could be used as an adjunct to clinical examination to diagnose an incomplete expulsion, it does not accurately differentiate those women who require surgical intervention from those who do not.
Health‐related quality of life and physical ability among pregnant women with and without back pain in late pregnancy
Authors: Christina Olsson  , Lena Nilsson‐Wikmar
Published: March 2004

Background.  Back pain during late pregnancy is a frequent clinical problem. Very little is known about the impact of this symptom on the quality of life among pregnant women with back pain.

Objectives.  To study the influence of back pain and physical ability on quality of life in late pregnancy.

Methods.  One hundred and sixty women in the 34th−37th week of pregnancy and attending two different midwife receptions, were asked to fill out questionnaires including: general questions about background factors, the Disability Rating Index (DRI) to score the physical ability, and The Nottingham Health Profile (NHP) for assessing health‐related quality of life. Two groups were defined, with and without back pain.

Results.  One hundred and thirty‐six (85%) out of 160 screened women returned the questionnaire for evaluation. The 69 (51%) women with back pain rated significantly (p < 0.05) higher on the DRI; on NHP part I, sub scales sleep, energy, pain, physical functioning and total score; and on NHP part II, aspects occupation, ability to perform jobs around the house, social life and hobbies compared with women without back pain.

Conclusions.  Irrespective of back pain the pregnant women studied featured lower quality of life (QOL) compared with published data on healthy women. Among the women with back problems, who had the most impaired QOL, the factors affecting QOL were mostly related to physical ability.