bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual characteristics, institutional incentives and electoral abstention in Western Europe
Authors: Perea Eva Anduiza
Published: March 2003

Abstract. This article examines the interaction between individual characteristics and institutional incentives in non–voting, with a special focus on the interaction between these two types of explanatory variables. The analysis of survey and contextual data for parliamentary elections in 15 Western European countries shows that the effect of individual resources and motivations on abstention is not constant across different countries. Conversely, the effect of institutional incentives (compulsory voting, voting facilities, electoral thresholds of representation and preference expression) on non–voting depends on the elector's level of resources and motivations. One of the four institutional incentives considered has even opposite effects for citizens with different individual characteristics. The analysis also shows that when analysing interactions it is fundamental to distinguish between magnitudes and consequences of the effects of explanatory variables. This has important implications for the interpretation of the results of logistic regression analysis.
Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement
Authors: Bonomi Amy E. , Wagner Edward H. , Glasgow Russell E. , VonKorff Michael
Published: March 2003

Objective. To describe initial testing of the Assessment of Chronic Illness Care (ACIC), a practical quality‐improvement tool to help organizations evaluate the strengths and weaknesses of their delivery of care for chronic illness in six areas: community linkages, self‐management support, decision support, delivery system design, information systems, and organization of care.

Data Sources. (1) Pre‐post, self‐report ACIC data from organizational teams enrolled in 13‐month quality‐improvement collaboratives focused on care for chronic illness; (2) independent faculty ratings of team progress at the end of collaborative.

Study design. Teams completed the ACIC at the beginning and end of the collaborative using a consensus format that produced average ratings of their system's approach to delivering care for the targeted chronic condition. Average ACIC subscale scores (ranging from 0 to 11, with 11 representing optimal care) for teams across all four collaboratives were obtained to indicate how teams rated their care for chronic illness before beginning improvement work. Paired t‐tests were used to evaluate the sensitivity of the ACIC to detect system improvements for teams in two (of four) collaboratives focused on care for diabetes and congestive heart failure (CHF). Pearson correlations between the ACIC subscale scores and a faculty rating of team performance were also obtained.

Results. Average baseline scores across all teams enrolled at the beginning of the collaboratives ranged from 4.36 (information systems) to 6.42 (organization of care), indicating basic to good care for chronic illness. All six ACIC subscale scores were responsive to system improvements diabetes and CHF teams made over the course of the collaboratives. The most substantial improvements were seen in decision support, delivery system design, and information systems. CHF teams had particularly high scores in self‐management support at the completion of the collaborative. Pearson correlations between the ACIC subscales and the faculty rating ranged from .28 to .52.

Conclusion. These results and feedback from teams suggest that the ACIC is responsive to health care quality‐improvement efforts and may be a useful tool to guide quality improvement in chronic illness care and to track progress over time.
Does Prospective Payment Really Contain Nursing Home Costs?
Authors: Chen Li‐Wu , Shea Dennis G.
Published: March 2003

Objective. To examine whether nursing homes would behave more efficiently, without compromising their quality of care, under prospective payment.

Data Sources. Four data sets for 1994: the Skilled Nursing Facility Minimum Data Set, the Online Survey Certification and Reporting System file, the Area Resource File, and the Hospital Wage Indices File. A national sample of 4,635 nursing homes is included in the analysis.

Study Design. Using a modified hybrid functional form to estimate nursing home costs, we distinguish our study from previous research by controlling for quality differences (related to both care and life) and addressing the issues of output and quality endogeneity, as well as using more recent national data. Factor analysis was used to operationalize quality variables. To address the endogeneity problems, instrumental measures were created for nursing home output and quality variables.

Principal Findings. Nursing homes in states using prospective payment systems do not have lower costs than their counterpart facilities under retrospective cost‐based payment systems, after quality differences among facilities are controlled for and the endogeneity problem of quality variables is addressed.

Conclusions. The effects of prospective payment on nursing home cost reduction may be through quality cuts, rather than cost efficiency. If nursing home payments under prospective payment systems are not adjusted for quality, nursing homes may respond by cutting their quality levels, rather than controlling costs. Future outcomes research may provide useful insights into the adjustment of quality in the design of prospective payment for nursing home care.
‘Taken at the Flood’? The German General Election 2002
Authors: Roberts Geoffrey K.
Published: March 2003

The outcome of one of the closest elections in the German Federal Republic's history partly resulted from the serious flooding which occurred a few weeks before polling day, allowing the government to display its concern in eastern Germany. There the SPD won votes, at the expense of the PDS, which returned to the Bundestag with only two representatives. The Christian Democrats did well in Bavaria. The small increase in votes for the liberal FDP and the large increase in support for the Greens meant that the incumbent coalition could continue, with a reduced majority. Significant economic problems will challenge the new government.
Futurology as Further Ideology: Reflections on Pryor's Millennium Survey of Economists
Authors: McGuire Patrick
Published: March 2003

This comment is in response to Frederic L. Pryor (2000). “The Millennium Survey: How Economists View the U.S. Economy in the 21st Century.”The American Journal of Economics and Sociology. 59 (January), pp. 3‐33.
H. G. J. as Biographer's Subject: Some Autobiographical Writings
Authors: Moggridge D.E.
Published: March 2003

In the last decade of his life, Harry Johnson (1923–1977) wrote a number of autobiographical pieces. He published three relating to his periods in Cambridge (1946–47 and 1949–55), but he did not publish two long autobiographical notes and a series of memoirs of his undergraduate career at the University of Toronto (1939–43), his first teaching job as the entire economics department at St. Francis Xavier University in Antigonish, Nova Scotia (1943–44) and his later period in England (1966–74). This material provides a number of clues as to the way Harry wished to be remembered and the paper develops some of the strongest autobiographical themes common to them.
Focus on Economic Sociology A Principal‐Agent Analysis of the Family: Implications for the Welfare State
Authors: Munro Lauchlan T.
Published: March 2003

This paper suggests that a principal‐agent perspective may be one of several useful ways of analyzing the family. The principal‐agent literature has so far ignored an important set of cases where the principal is incapable of defining and defending her own interests, and so is assigned an agent by law or custom. This paper applies principal‐agent analysis to one such case, the family, where the child is taken as the principal and the parent is her agent. The principal‐agent problem within families creates a prima facie case for certain state interventions to protect the interests of child‐principals. The principal‐agent perspective on the family sheds new light on two old debates: about provision of state welfare services in cash or in kind, and about user fees for social services.
Custom and the Firm
Authors: Groenewegen John
Published: March 2003

This comment is part of a symposium on Ekkehart Schlicht, On Custom in the Economy (1998)
The Prophecy of Place: A Labor Market Study of Young Women and Education
Authors: Williams L. Susan
Published: March 2003

This study demonstrates that place—defined in this article as labor market area (LMA)— provides a useful context for examining how youth manage gendered situations. Places vary by conditions in which gender is more, less or differently salient, and a particular mix of factors accommodates different individual outcomes. This study utilizes multi–level modeling to examine influence of LMA characteristics on over–time educational measures for young women (Center for Human Resource Research 1994). Hierarchical models determine place–level effects on both average outcomes (within and between LMAs) and attainment processes. A major finding of this study is that aggregate place effects channel personal decisions and outcomes of young women. Young women’s educational aspirations are dependent on gender– specific variables such as the number of women in college or the number of young women married in a local area. Attainment depends on the percentage of women in higher education and a local labor market’s average age at first marriage. Further, what are assumed to be positive environmental effects (e.g., manufacturing dominance) are based on structural advantages for men and actually depress outcomes for women. Notably, the influence of place is independent of strong individual–level determinants, including social class.
Advertising and Political Bias in the Media: The Market for Criticism of the Market Economy
Authors: Sutter Daniel
Published: March 2003

Many observers of the media argue that advertiser support of the news insulates business from critical scrutiny. News organizations know better than to bite the hand that feeds them. I examine several weaknesses in this corporate advertising bias argument. Most significantly, a favorable political climate for business is a public good, so individual businesses have an incentive to support anti–business messages that generate an audience. Transmission of messages that fail to generate sufficient demand is inefficient. In short, advertising does not create a significant political bias.
Efficiency considerations and the exemption of food from sales and value added taxes
Authors: Iorwerth Aled ab , Whalley John
Published: March 2003

We evaluate efficiency considerations underlying the widespread exemption of food from sales and value added taxes and the implications for tax policy. Household and restaurant meals and both constant and increasing returns cases are examined. Higher taxes on food offset the non‐taxation of time inputs into household production, even under constant returns to scale. With increasing returns, gains from taxing food are higher and amplified by subsidizing restaurant food and all marginal cost components of restaurant meals. On efficiency grounds, exemption of food from sales and value added taxes emerges as socially costly policy, especially under increasing returns.

Considérations d’efficacité et l’exemption de la nourriture dans les taxes de vente et les taxes sur la valeur ajoutée. Les auteurs examinent les questions d’efficacité qui soustendent l’exemption généralisée de la nourriture des taxes de vente ou des taxes sur la valeur ajoutée, ainsi que les implications qui en découlent pour la politique de taxation. On examine la consommation par les ménages et dans les restaurants à la fois pour le cas où les rendements sont constants et croissants. Des taxes plus élevées sur la nourriture compensent pour la non‐imposition du temps en tant qu’intrant dans la production des ménages même quand il y a rendements constants à l’échelle. Quand on a des rendements croissants, les gains provenant de l’imposition de la taxe sur la nourriture sont accrus et amplifiés par la subvention à la nourriture de restaurant et toutes les composantes du coût marginal des repas au restaurant. Au plan de l’efficacité, l’exemption de la nourriture des taxes de vente ou des taxes sur la valeur ajoutée apparaît comme une politique socialement coûteuse, particulièrement quand les rendements sont croissants.
Congestible communications networks and international trade
Authors: Kikuchi Toru , Ichikawa Tetsuro
Published: March 2003

We build a two‐country model of monopolistic competition with communications networks. A communications network is characterized by (1) the existence of large fixed costs of network provision, and (2) the presence of congestion. It is demonstrated that both the size of a country and the relative magnitude of the congestion effect determine its comparative advantage: if the congestion effect (resp., the cost‐sharing effect) prevails universally, a comparative advantage in the goods that require communications is held by the smaller (resp., larger) of the two countries. JEL Classification: D43, F12

Réseaux de communication, congestion et commerce international. Ce mémoire présente un modèle de concurrence monopolistique à deux pays avec des réseaux de communication. Un réseau de communication est caractérisé par (1) l’existence de coûts fixes importants pour la mise en place du réseau et (2) la présence de congestion. On montre que la taille du pays et la magnitude relative de la congestion déterminent l’avantage comparatif : si l’effet de congestion (ou respectivement l’effet de partage des coûts) prévaut, un avantage comparatif dans les biens qui demandent plus de communication est détenu par le plus grand (respectivement le plus petit) des deux pays.
Aggregation bias, compositional change, and the border effect
Authors: Hillberry Russell H.
Published: March 2003

Borders affect the composition, not only the level, of interregional trade. In disaggregated U.S. Commodity Flow data, border effects vary substantially across commodities. Substantial border–induced compositional change suggests the possibility that standard estimates suffer from aggregation bias arising from endogenous industry location patterns and the presence of zero observations in commodity–level trade. Adjusting for these effects reduces the estimate of the aggregate border effect from 20.9 to 5.7. JEL Classification: F14, F15

Biais d’agrégation, changement de composition, et effet de frontières. Les frontières affectent la composition et pas seulement le volume de commerce inter‐régional. Une analyse des données désagrégées des flux de commerce de biens des Etats‐Unis montre que l’effet de frontières varie substantiellement selon les biens. Le changement de composition du commerce engendré par les frontières suggère la possibilité que les estimations usuelles souffrent d’un biais d’agrégation résultant des patterns de localisation industrielle endogènes et de la présence d’observations nulles dans le commerce de certains biens. Un ajustement pour tenir compte de ces effets suggère que les effets de frontières passent de 20.9 à 5.7.
Post–Plaza intervention in the DEM/USD exchange rate
Authors: Fatum Rasmus
Published: March 2003

In this paper, whether specific methods of conducting central bank interventions increase the likelihood of achieving its objectives in analysed. Daily Bundesbank and Fed intervention data covering the entire Post–Plaza period are used to estimate binary choice models over the sample of observations when at least one of the two central banks were intervening. The results suggest that central banks can, in fact, improve the likelihood of success primarily through coordination and that unilateral intervention conducted by the Bundesbank appears to have been destabilizing. Furthermore, it is shown that relatively infrequent intervention has a higher likelihood of success. JEL classification: E58, F31, F42, G15

Intervention dans le monde du taux de change dollar/mark après l’Accord de Plaza. Ce mémoire explore la question à savoir si des méthodes spécifiques d’intervention par la banque centrale accroissent la probabilité que les objectifs soient atteints. A l’aide de données sur l’impact des interventions de la Bundesbank et de la Federal Reserve pour toute la période qui a suivi l’Accord de Plaza, on calibre les modèles de choix binaires pour l’échantillon des données quand au moins l’une des deux banques centrales est intervenue. Les résultats suggèrent que les banques centrales peuvent en fait améliorer la probabilité de succès dans la poursuite des objectifs via la collaboration et que les interventions unilatérales de la Bundesbank semblent avoirété déstabilisantes. De plus, il semble que des inteerventions relativement moinsfréquentes ont une plus grande probabilité de succès.
Crises, Cronyism, and Credit
Authors: Pagano Michael S.
Published: March 2003

This paper examines the effects of several potential explanatory factors related to the 1997–1998 East Asian crisis. We find that a crisis can improve a poorly functioning credit system by making domestic lending rates more responsive to market‐based returns. We report that the responsiveness of short‐term lending rates is directly related to the level of transparency in the economy. Thus, countries with greater transparency (less corruption) are more likely to make credit decisions based on market‐wide forces rather than succumb to the influence of special interest groups. Nations with greater transparency also experience significantly shorter and less severe economic downturns.
Determinants of Institutional Responses to Self–Tender Offers
Authors: Swisher Judith
Published: March 2003

I examine how institutional investors respond to self–tender offers for common shares. I find that institutions sell more shares in larger offers and with higher proration factors. Institutions also sell more shares when officer and director holdings are not at risk in the offers. Banks, investment advisors, and other managers respond similarly, selling more shares in larger offers. Although institutions as a group do not respond differently by offer type, insurance companies and investment advisors sell more shares in fixed–price offers. Mutual funds, which differ from other types of institutions, sell more shares for firms with greater increases in leverage.
Idols and Demons: On Discerning the Spirits
Authors: Westhelle Vitor
Published: March 2003

This article elaborates on the distinction between two spiritual ailments, which can be properly identified as idolatry and demonry. They represent opposite but complementary age–long phenomena still relevant to the analysis of the contemporary spiritual situation in explaining disorders of the soul as well as cultural derangement. The text suggests that the church as the spiritual community is the locus for the discernment of the spirit and that in its two distinguishing foundational and functional features (the proclamatory function and the communion function) it is molded precisely to confront both idols and demons.
Pentecostals: The Power of the Powerless
Authors: Sjørup Lene
Published: March 2003

Many researchers interpret Pentecostalism in terms of external factors such as European and North American history or economics. In this article Pentecostalism is examined from below, through qualitative interviews with women living in poverty in Santiago, Chile. The analysis shows how Pentecostalism led to a new theology where the believer became the subject of her own life. Social ascent was made through ecstatic experiences of the spirit in a caring community which directed the individual towards “a female ethos.” This subjective change affected social changes in Chile under dictatorship but not in state politics because parts of the Pentecostal hierarchy collaborated with Pinochet.
Discerning the Spirit among Catholic Charismatics
Authors: Gelpi Don
Published: March 2003

The “Catholic Charismatic Renewal,” renamed by the bishops the “Charismatic Renewal of the Church,” has a 35 year history in the US and Europe. Debated at Vatican II and analyzed by theologians, the experience of spiritual charisms requires thoughtful discernment, especially if charism is to be properly integrated with sacrament.
Dominus Iesus as Ecumenical Shock
Authors: Welker Michael
Published: March 2003

The Roman Catholic declaration of 2000, Dominus Iesus, shocked the ecumenical world by declaring that Protestant churches are not “churches in the proper sense.” The two reasons given are that Protestants fail to maintain a valid episcopate and the fail to celebrate genuinely the Eucharistic mystery. This article takes up the latter claim by defending Protestantism and pleading for Roman Catholic self–correction, specifically opposing private masses and requiring the gathered community to celebrate the Eucharist.
Ten Theses on the Future of Lutheran Theology Charisms, Contexts, and Challenges
Authors: Gregersen Niels
Published: March 2003

Although Lutheran theology is a gift to the historic church, Martin Luther’s own views are specifically formulated for their 16th century context. No universal or timeless theological system based upon Luther’s authority should be appealed to. Then theses are here advanced that bridge the 16th and 21st centuries and challenge us to creative construction.
Volo ut sis: Arendt and Augustine
Authors: Miles Margaret
Published: March 2003

This article focuses on Hanna Arendt’s use of love in her writings. More specifically, I contend that Arendt’s use of volo ut sis (I want you to be) and labeling of this type of love as Augustinian, takes what Augustine meant by “love” too far.
BROMEMOSAICVIRUSRNA REPLICATION: Revealing the Role of the Host in RNA Virus Replication
Authors: Noueiry Amine O. , Ahlquist Paul
Published: March 2003

▪ Abstract  The replication of positive-strand RNA viruses is a complex multi-step process involving interactions between the viral genome, virus-encoded replication factors, and host factors. The plant virus brome mosaic virus (BMV) has served as a model for positive-strand RNA virus replication, recombination, and virion assembly. This review addresses recent findings on the identification and characterization of host factors in BMV RNA replication. To date, all characterized host factors facilitate steps that lead to assembly of a functional BMV RNA replication complex. Some of these host factors are required for regulation of viral gene expression. Others are needed to co-regulate BMV RNA translation and recruitment of BMV RNAs from translation to viral RNA replication complexes on the endoplasmic reticulum. Other host factors provide essential lipid modifications in the endoplasmic reticulum membrane or function as molecular chaperones to activate the replication complex. Characterizing the functions of these host factors is revealing basic aspects of virus RNA replication and helping to define the normal functions of these factors in the host.
Endotoxin Stimulates Leptin in the Human and Nonhuman Primate
Authors: Landman Rita E. , Puder Jardena J. , Xiao Ennian , Freda Pamela U. , Ferin Michel , Wardlaw Sharon L.
Published: March 2003

Leptin, which plays a key role in regulating energy homeostasis, may also modulate the inflammatory response. An inflammatory challenge with endotoxin has been shown to stimulate leptin release in the rodent. This finding has not been reproduced in humans or in nonhuman primates, although leptin levels have been reported to increase in septic patients. We have therefore examined the effects of endotoxin injection on plasma leptin levels in nine ovariectomized monkeys and four postmenopausal women. In an initial study in five monkeys, mean leptin levels did not increase during the first 5 h after endotoxin treatment, but did increase significantly from 6.4 ± 2.1 ng/ml at baseline to 12.3 ± 4.4 ng/ml at 24 h (P = 0.043). In a second study, a significant increase in leptin over time was noted after endotoxin treatment (P < 0.001); leptin release during the 16- to 24-h period after endotoxin injection was 48% higher than during the control period (P = 0.043). A similar stimulatory effect of endotoxin on leptin was observed when monkeys received estradiol replacement. In a third study, repeated injections of endotoxin over a 3-d period stimulated IL-6, ACTH, cortisol, and leptin release (P < 0.001). Leptin increased during the first day of treatment in all animals, but only monkeys with baseline plasma leptin levels greater than 10 ng/ml exhibited a sustained increase in leptin throughout the 3-d period. There was a significant correlation (r = 0.81; P = 0.008) between the mean baseline leptin level and the percent increase in leptin over baseline on the last day of treatment. In the human subjects, plasma leptin concentrations did not change significantly during the 7-h period after endotoxin injection. However, leptin increased in all four women from a mean baseline of 8.34 ± 3.1 to 13.1 ± 4.3 ng/ml 24 h after endotoxin (P = 0.038). In summary, endotoxin stimulates the release of leptin into peripheral blood in the human and nonhuman primate, but the time course is different from that reported in the rodent. These results are consistent with previous reports of increased blood leptin levels in patients with sepsis. The significance of these findings and the potential role of leptin in modulating the response to inflammation in the human require further study.
Leukotriene (LT)‐receptor antagonist is more effective in asthmatic patients with a low baseline ratio of urinary LTE4 to 2,3‐dinor‐6‐keto‐prostaglandin (PG)F1α
Authors: Tanaka H , Saitoh T , Kurokawa K , Teramoto S , Miyazaki N , Kaneko S , Hashimoto M , Abe S
Published: March 2003

Background: To test the hypothesis that urinary levels of arachidonic acid metabolites may be a predicting factor of the effects of pranlukast, a selective leukotriene (LT) antagonist, on chronic adult asthma, we investigated the relationship between its clinical efficacy and urinary eicosanoid levels.

Methods: An open, multicenter trial was conducted involving 38 stable moderate and severe asthmatic patients (mean percent predicted FEV1 was 71%). All patients received pranlukast (225 mg twice daily) for 4 weeks after a 2‐week run‐in period. Urinary levels of LTE4, 11‐dehydro‐thromboxane (TX) B2, 2,3‐ dinor‐6‐keto‐prostaglandin (PG) F1α, and creatinine were measured in 3‐h urine collected on day 1 of the treatment. The responder was defined by an improvement of asthma symptom scores and peak expiratory flow rate (PEFR).

Results: One patient was excluded because of an adverse effect, nausea. Thirteen out of 37 subjects were responders and 24 were nonresponders. There were no significant differences in patients' backgrounds and urinary arachidonate levels between the two groups. The urinary LTE4 to 2,3‐dinor‐6‐keto‐PGF1α ratio in the responder was significantly lower (P=0.01) than that in the nonresponder. In all patients, a significant inverse correlation was revealed between the baseline urinary LTE4/2,3‐dinor‐6‐keto‐PGF1α ratio and the improvement of PEFR in the morning (r=−0.43, P=0.007).

Conclusions: These data suggested that the urinary ratio of LTE4 to 2,3‐dinor‐6‐keto‐PGF1α might be one of the predictive markers of the clinical efficacy of this LT‐receptor antagonist in asthmatic subjects.
Measurement of interstitial cetirizine concentrations in human skin: correlation of drug levels with inhibition of histamine‐induced skin responses
Authors: Petersen LJ , Church MK , Rihoux J‐P , Skov PS
Published: March 2003

Background: The purpose of the present study was to measure the concentrations of cetirizine in the extracellular water compartment in intact human skin and assess simultaneously inhibition of histamine‐induced wheal and flare reactions.

Methods: Skin cetirizine levels were collected by the microdialysis technique and analyzed by high‐pressure liquid chromatography with mass spectrometry detection. Skin levels in 20 subjects were compared to plasma levels for 4 h after a single oral dose of 10 or 20 mg of cetirizine. Skin prick tests were performed with histamine 100 mg/ml.

Results: Plasma cetirizine levels increased within 30 min to reach peak values of 315±10 and 786±45 ng/ml 90–120 min after administration of 10 and 20 mg of cetirizine. This was followed by a slow decline. In the skin, dialysate cetirizine levels (non‐protein‐bound fraction only) peaked at 1.6±0.1 and 2.4±0.3 ng/ml at 120–180 min. In vivo recovery of cetirizine was 14.4±4.3%. It was estimated that the non‐protein‐bound concentration of cetirizine in the skin was 50–70% of corresponding plasma values. Both 10‐ and 20‐mg doses of cetirizine inhibited wheal and flare reactions over 240 min. The time vs concentration profile of cetirizine in skin dialysate paralleled the inhibition of skin reactions, but no significant correlations were found between individual cetirizine levels in skin or plasma with wheal and flare reactions.

Conclusions: Cetirizine concentrations in the skin could be monitored by the microdialysis technique. The results indicate no simple linear correlation between cetirizine skin levels and inhibition of skin reactions.
Fatty acids in substitute formulas for cow's milk allergy
Authors: Kaila M , Salo Mk , Isolauri E
Published: March 2003

Background: The role of dietary fats in food‐related allergic symptoms is increasingly being investigated, since the pivotal role of fat‐derived inflammatory substances, e.g., leukotrienes, has been realized. The objective of this study was to describe the fatty acid composition of several commercially available infant formulas that are used as substitutes for adapted cow's milk formulas.

Methods: Samples of nine formulas (two soy, two extensively hydrolyzed casein, three extensively hydrolyzed whey, and two amino‐acid‐based formulas) and human milk as control were analyzed by gas chromatography.

Results: The quantity of fatty acids in the formulas was within the breast‐milk range. The percentage of energy derived from fat was below the European Society for Pediatric Gastroenterology and Nutrition recommendations in two cases, but, in the others, it roughly met the recommendations. The percentage of energy derived from linoleic acid was as recommended in all but two cases, where it was higher than recommended. As indicated by a quality indicator, the linoleic to α‐linolenic acid ratio, altogether four formulas were within either the recommendations or the analyzed breast‐milk range. In three cases, it was 1.5–2.5 and in two cases 4–5 times higher than recommended.

Conclusions: There are recommendations for infant formulas to meet nutritional requirements of fat intake, and the analyzed formulas are in most cases within the suggested ranges. However, little is known of requirements in allergic or inflammatory conditions, and whether these described fatty acid compositions are pro‐ or anti‐inflammatory.
Occurrence of allergic conditions in asthmatics with analgesic intolerance
Authors: Kalyoncu AF , Karakaya G , Şahin AA , Barış Yİ
Published: March 2003

Background: The study aimed to determine whether allergic conditions accompany analgesic intolerance.

Methods: A total of 132 analgesic‐intolerant patients with bronchial asthma admitted to the adult allergy unit from January 1991 to October 1997 and 103 patients with bronchial asthma randomly selected from among the asthmatics referred to our department between January and October 1997 were enrolled in the study. Those having analgesic intolerance and bronchial asthma were accepted as group I; patients having only asthma were accepted as group II. A standard questionnaire was completed for all the patients. Physical examination, routine skin prick tests, determination of total IgE levels and blood type, and oral analgesic provocation tests were also performed.

Results: The results showed that some allergic conditions were significantly more common in group I (22.7% and 7.8% for food allergy/intolerance [P<0.05], 16.7% and 7.8% for antibiotic allergy, 16.7% and 2.9% for dermographism, 9.8% and 1.0% for metal allergy, and 9.1% and 1.0% for chronic urticaria for groups I and II, respectively [P<0.001]). In addition, the mean of the total IgE level in the serum was higher in group I than group II (77.6 and 53.7 IU/ml; P<0.05), and the cumulative analgesic consumption was more in group I (14.2±17.1 and 9.1±12.5 boxes; P<0.05).

Conclusions: Dermographism; chronic urticaria; antibiotic, metal, and food allergy; high levels of total IgE; and a high amount of cumulative analgesic consumption may be the conditions accompanying analgesic intolerance in asthmatics.
Occurrence of dog, cat, and mite allergens in public transport vehicles
Authors: Partti‐Pellinen K. , Marttila O. , Mäkinen‐Kiljunen S. , Haahtela T.
Published: March 2003

Background and methods: Helsinki City Transport buses, trams, and underground trains carry 687 000 passengers on a weekday. Of the passengers, 0.13% travel with a pet. We interviewed passengers and measured allergen levels in vehicles to study what difficulties allergens cause to passengers with allergy and asthma.

Results: Of 2021 interviewed passengers, 14% complained about inconvenience caused by pets, usually health problems. Of 324 adult passengers with allergy or asthma, 53% had experienced symptoms in public transport; the corresponding figure for 75 children was 32%. The median concentration of the main dog allergen, Can f 1, in dust from seats and floors in public transport vehicles was 2400 ng per g of dust (range 20–8.500 ng/g). For the main cat allergen, Fel d 1, the median was 870 ng/g (range 3–2.600 ng/g). These levels can be regarded as low or moderate, and cause symptoms in sensitive persons. Concentrations of mite allergens were undetectable or low. Allergen levels were lower in vehicles where pets were not allowed than in vehicles where pets were allowed, lower in dust from uncovered seats than in dust from seats with a covering, and lower after cleaning vehicle floors and seats than before cleaning.

Conclusions: Dog and cat allergens are present in public transport vehicles in Helsinki at levels that cause symptoms in sensitive persons. Prohibiting pets would probably bring only a modest reduction in levels, as few pets are carried, and much allergen contamination comes from passengers' clothes.
Different airway responsiveness profiles in atopic asthma, nonatopic asthma, and Sjögren's syndrome
Authors: Lúdvíksdóttir D. , Janson C. , Björnsson E. , Stålenheim G. , Boman G. ,   BHR Study Group, Hedenström H. , Venge P. , Gudbjörnsson B. , Valtýsdóttir S.
Published: March 2003

Background: Different mechanisms may underlie bronchial hyperresponsiveness (BHR) in different diseases. The aim of this study was to investigate the bronchial responsiveness profile produced by three different challenge tests, methacholine, a direct simulus, and two indirect stimuli, adenosine 5′‐monophosphate (AMP) and cold air, in subjects with asthma and patients with Sjögren's syndrome.

Methods: The study population comprised 40 adult patients with asthma, 18 subjects with Sjögren's syndrome, and 20 controls. Blood samples were collected before each challenge for measurements of serum eosinophil peroxidase (S‐EPO) and eosinophil cationic protein (S‐ECP). The investigated subjects recorded peak expiratory flow and kept a symptom diary.

Results: Atopic subjects with asthma were significantly more hyperresponsive to AMP than nonatopic subjects with asthma (P=0.01) and subjects with Sjögren's syndrome (P=0.02). No difference was seen between atopic and nonatopic subjects with asthma in the case of challenges with methacholine or cold air. In atopic subjects with asthma, a significant correlation was found between challenges with methacholine and AMP (r=0.91, P=0.0001) and methacholine and cold air (r=0.83, P=0.004), but, in nonatopic subjects with asthma, no significant correlation was seen between methacholine and AMP or cold air challenges. In atopic subjects with asthma, the dose‐response slope for AMP was correlated to S‐EPO (r=−0.56; P=0.01) and S‐ECP (r=−0.51, P=0.02), while no correlation between BHR and inflammation markers was found in the two other patient groups.

Conclusions: The results of this study suggest that patients with asthma and subjects with Sjögren's syndrome display different bronchial responsiveness profiles for different challenge agents. Atopic subjects with asthma are more hyperresponsive to AMP than nonatopic subjects and patients with Sjögren's syndrome. More than one challenge may be required to detect different aspects of bronchial responsiveness.
Short communication. Cetirizine inhibits bradykinin‐induced cutaneous wheal and flare in atopic and healthy subjects
Authors: Fadel R. , Ramboer I. , Chatterjee N. , Rihoux J‐P. , Derde M‐P.
Published: March 2003

Background: Kinins are vasoactive mediators involved in allergic reactions. When applied on the skin or in the nose, bradykinin (BK) elicits inflammation that is poorly affected by previous H1‐blockade. The aim of this study was to compare the possible effect of cetirizine (an H1‐antagonist) on wheal and flare responses to BK, histamine, and compound 48/80 in atopic and healthy subjects.

Methods In a randomized, double‐blind, crossover study, eight atopic and eight healthy subjects received cetirizine (10 mg/day) or placebo for 3 days before cutaneous tests. Intradermal tests (IDT) and prick tests (PT) were performed with BK (20 nmol/ml for IDT and 20 µmol/ml for PT), histamine (100 µg/ml IDT and 100 mg/ml PT), and compound 48/80 (100 µg/ml IDT and 100 mg/ml PT) as positive controls and saline as negative control. The skin responses were monitored by measurement of wheal and flare areas.

Results: BK, histamine, and 48/80 induced wheal and flare reactions in all placebo‐treated subjects. Histamine elicited larger wheal and flare reactions than BK and 48/80. IDT with BK induced four‐ to six‐fold larger wheal and flare reaction than PT. No differences in BK‐induced wheal and flare were observed between atopic and healthy subjects. In atopic subjects, cetirizine induced a significant reduction of flare reactions after the BK test (80% for IDT, and 94% for PT [P<0.01]). Moreover, cetirizine reduced significantly BK‐induced wheals by 70% for IDT (P<0.01) and 65% for PT (P<0.01). A similar inhibiting effect of cetirizine was also observed in healthy subjects.

Conclusions: These findings showed that the wheal and flare reactions induced by BK challenge were markedly inhibited by previous intake of cetirizine. The mechanism by which this effect is mediated cannot be established at present.
Monoclonal antibody‐based method to quantify Gly m 1. Its application to assess environmental exposure to soybean dust
Authors: González R. , Duffort O. , Calabozo B. , Barber D. , Carreira J. , Polo F.
Published: March 2003

Background: The demonstration that some asthma epidemics have been caused by allergens of soybean‐hull dust prompted us to develop a two‐site ELISA, suitable for the quantification of the major allergen (Gly m 1), to be used for the prevention of new episodes.

Methods: BALB/c mice were injected with Gly m 1 purified from soybean hulls. After fusion and screening, 10 monoclonal antibodies (mAbs) were obtained that were shown to be specific for Gly m 1. Two of them (6G1 as the capture antibody; 1G10 as the tracer) were selected to develop a quantitative two‐site ELISA for the indoor and outdoor determination of Gly m 1.

Results: The two‐site ELISA developed is very sensitive, with a detection limit of less than 0.2 ng/ml and a practical working range of 0.4–10 ng/ml. The assay is also highly reproducible with an intra‐assay coefficient of variation of 3.5% and an interassay coefficient of variation of 12.5%. The method was applied to measure the concentration of Gly m 1 in air‐sampler filters and in house‐dust samples. Our results illustrate that there is a good correlation between the content of Gly m 1 in a number of samples and the allergenic activity as measured by ELISA inhibition.

Conclusions: A specific and sensitive method is presented that can be used for the quantification of Gly m 1. The application of this method may allow the establishment of risk limits for soybean dust, and thus may contribute to the control of environmental contamination and to the prevention of new asthma epidemics.
Early effect of ultrarush venom immunotherapy on the IgG antibody response
Authors: Michils A. , Baldassarre S. , Ledent C. , Mairesse M. , Gossart B. , Duchateau J.
Published: March 2003

Background: We have previously shown in several allergy models that allergic and tolerance status with respect to allergens is associated with a somewhat different dominant specificity of IgG antibodies. The objective was to test this hypothesis in the compelling model of ultrarush venom immunotherapy (VIT), which induces clinical tolerance after only a few hours of treatment.

Methods: Antibody titers and specificity were evaluated through solid‐phase ELISA using streptavidin‐biotin technology in 12 patients allergic to wasp venom before and during the ultrarush procedure (at 12 h, 24 h, and 15 days). The results were compared with those from another group of 20 patients treated with venom injections for at least 2 years.

Results: No significant change was observed in IgG titers during the early phase of VIT. The capacity of individual sera to prevent the antigen binding of pooled IgG from allergic patients changed rapidly, with mean percentage inhibitions falling from 80±15%, before starting VIT, to 26±14%, 35±15%, and 34±5% after 12 h, 24 h, and 15 days of treatment, respectively (P<0.001 by one‐way ANOVA). The capacity of individual sera to prevent the antigen binding of pooled IgG from patients receiving prolonged VIT changed, with mean percent inhibitions increasing from 47±8%, before starting VIT, to 76±7%, 83±6%, and 87±6% after 12 h, 24 h, and 15 days of treatment, respectively (P<0.001 by one‐way ANOVA).

Conclusions: During the initial phase of ultrarush VIT, a change in IgG specificity, i.e., a change in the set of epitopes dominantly recognized by IgG on wasp‐venom antigens, occurred concomitantly with early clinical tolerance and was already detectable a few hours after the onset of treatment. Although it may be an epiphenomenon, this change represents the earliest humoral modification described so far during this procedure. The mechanism is unknown, but it appears to be a selective depletion of the highest avidity antibody fraction by the venom injected in large doses at this stage of therapy. Finally, our data now show the previously documented association between a particular IgG specificity and the clinical status (allergy vs tolerance) to be true also with ultrarush VIT, a model in which the clinical ability to display allergic symptoms is rapidly reversed.
Eosinophil cationic protein and eosinophil protein X in the nasal lavage of children during the first 4 weeks of life
Authors: Halmerbauer G. , Gartner C. , Koller D. , Schierl M. , Kühr J. , Forster J. , Urbanek R. , Frischer T. ,   and the Space Collaborative Study Team
Published: March 2003

Eosinophil cationic protein (ECP) and eosinophil protein X (EPX) are well established as markers of eosinophil activation. We analyzed ECP and EPX concentrations in nasal lavage fluids (NALF) of 378 neonates during their first 4 weeks of life. Inclusion criteria were a positive history of parental allergy and a positive skin prick test or specific IgE (RAST class ≥2) against at least one out of a panel of common aeroallergens in one or both parents. Twenty‐four infants with no history of parental allergy were used as controls. A volume of 2 ml of 0.9% saline was instilled into each nostril and immediately recovered by a suction device. ECP and EPX were analyzed by radioimmunoassay. In 65 samples of three consecutive lavages, EPX was detected in nine samples (13.8%) in the control group, whereas it was detected in 197/360 samples (54.7%) in the study population. The corresponding figures for ECP were 17/65 (26.2%) in the control group and 173/365 (47.4%) in the study group. Both proteins showed a skewed distribution (median/5–95th percentiles for ECP: 0 µg/l [0–69.4] and EPX: 6.6 µg/l [0–73.2]). The differences between the control group and the study group were statistically significant, regardless of the allergic disease of the parents. In children of allergic parents, activation proteins of the eosinophil granulocyte are released on the nasal mucosal surface in about 50% of the studied population at the age of 4 weeks. This early onset of eosinophil activation in the nasal respiratory epithelium may reflect a genetic predisposition to allergy or early exposure to allergens.
Distribution of dust‐mite allergens (Lep d 2, Der p 1, Der f 1, Der 2) in pig‐farming environments and sensitization of the respective farmers
Authors: Radon K. , Schottky A. , Garz S. , Koops F. , Szadkowski D. , Nowak D. , Radon K. , Nowak D. , Luczynska C.
Published: March 2003

Background: The aim of the present study was to determine the distribution of mite allergens in pig‐farming environments in comparison to urban homes and the relationship between exposure to mite allergens and sensitization to the respective allergens in 100 pig farmers with work‐related respiratory symptoms.

Methods: The concentration of storage mite (Lep d 2) and house‐dust‐mite (Der p 1, and Der f 1, Der 2) allergens in dust collected from five different sampling sites (floor, wall, grain mill, transit floor, and farmers' mattresses) was studied in relationship to the respective sensitization rates. Allergen concentrations in the mattresses were compared to those determined in mattresses from 22 urban dwellers.

Results: Median concentrations of Der p 1 and Der 2 in the mattresses of the farmers were significantly higher than in the urban dwellers' samples (53.4 μg/g dust vs 1.05 μg/g dust, P=0.001; 19.6 μg/g dust vs 2.2 μg/g dust, P<0.0001, respectively). Allergen concentrations in the transit areas were strongly related to bedroom exposure. In a multiple logistic regression model, a weak but significant relationship between Der p 1 exposure and sensitization to Der p 1 was found. Despite these findings, the prevalence of sensitization to mite allergens in the farmers (18%) was comparable to the prevalence in the general population.

Conclusions: Allergen exposure at the work place is strongly related to the concentration of allergens in farmers' beds. Exposure to domestic mite allergens should be taken into account when assessing occupational exposure to allergens and the respiratory health of farmers.
Severe hypersensitivity syndrome to lamotrigine confirmed by lymphocyte stimulation in vitro
Authors: Schaub N. , Bircher A. J.
Published: March 2003

Background: The anticonvulsant lamotrigine has been associated with severe adverse events such as the hypersensitivity syndrome and severe bullous reactions. So far, specific immunologic tests have rarely been performed to demonstrate specific sensitization.

Methods: A 36‐year‐old man suffering from epilepsy was concomitantly treated with high doses of sodium valproate and lamotrigine. About 1 month later, a severe hypersensitivity syndrome occurred affecting skin, lymph nodes, and liver. Three months later, skin tests and lymphocyte stimulation tests with anticonvulsants were performed.

Results: Skin tests were negative with all drugs; lymphocyte stimulation tests were twice positive with lamotrigine. Later re‐exposure to sodium valproate was tolerated.

Conclusions: Lamotrigine may elicit a severe hypersensitivity syndrome. Particularly high initial doses and concomitant treatment with sodium valproate increase the risk of cutaneous reactions. The lymphocyte stimulation test was used to identify the culprit drug. Lymphocyte sensitization to the drug or a metabolite may be involved in the pathogenesis.