bluuebunny/crossref_metadata_2025 huggingface dataset:
NAFTA and the Pollution Haven Hypothesis
Authors: Ederington Josh
Published: June 2007

The “Pollution Haven Hypothesis” is the prediction that trade liberalization will lead to the movement of polluting industries from high income/stringent environmental regulation countries to low income/lax environmental regulation countries. This prediction has led to concerns that NAFTA would be an environmental disaster for Mexico. The three articles included in this collection investigate the post‐NAFTA environmental performance of Mexico using both aggregate data on pollution emissions as well as firm‐level data on environmental abatement efforts. In this article, I summarize the contribution in the context of the trade/environmental literature and provide some suggestions for future work.
NAFTA's Impact on Business Environmental Decision Making
Authors: Domínguez‐Villalobos Lilia , Brown‐Grossman Flor
Published: June 2007

Signing the North American Free Trade Agreement (NAFTA) liberalized trade policy and reduced tariffs between Mexico, the United States, and Canada, but activists opposed to the treaty predicted an environmental disaster. This article seeks to analyze the dynamics of environmental spending and changes in companies' profiles following NAFTA. Our results suggest that these predictions have not come true. Through an econometric model, we explore how 2,438 industries in the 1994–2002 period made environmental decisions and how much they spent on cleanup. Estimates were made with a dynamic panel model using the generalized method of moments (GMM) method. Our results suggest that environmental investment decisions depended on business size, their technological capabilities, sales performance, and the need to comply with the standards required by customers in the international market. The last section explores policies to improve compliance with Mexico's environmental regulations and to develop sustainable, eco‐friendly manufacturing.
Testing a Partial Ordering of Population Means with Application to Inference about Growth Habits of Cowpea Genotypes
Authors: Jeske Daniel R. , Wang Guangyao , McGiffen Milton E.
Published: June 2007

Summary Using general results available in the literature, we derive the likelihood ratio test for a particular partial ordering of means that naturally arises in a biological context. We then show that the conceptual and computational complexity of the derivation can be substantially reduced by equivalently deriving the test using the intersection‐union principle for decomposing a complex null hypothesis into elemental forms. A Monte Carlo algorithm for obtaining the p‐value of the test is proposed. The test procedure is illustrated with a data set of the competitive ability of several cowpea genotypes, where previous experiments have indicated the proposed partial order of the means. A simulation study is used to examine the power of the test.
The Development of Renewable Electricity Policy in the Province of Ontario: The Influence of Ideas and Timing
Authors: Rowlands Ian H.
Published: June 2007

This article examines the development of policy to promote renewable electricity in the province of Ontario (Canada) between 1995 and 2006. Drawing upon both the role of ideas in policy development and a “multiple streams approach,” it is argued that changes in the problem, policy, and politics streams—and their coupling by key political entrepreneurs—account for two significant shifts in Ontario's efforts to promote the increased use of renewable electricity. The first shift occurred on July 3, 2003 when the Ontario Commissioner of Alternative Energy, Steve Gilchrist, announced that sole dependence upon free markets to support renewable electricity was being displaced by a new commitment to a renewable portfolio standard. The second shift occurred on March 21, 2006 when the Ontario Premier, Dalton McGuinty, announced that dependence upon a bidding system to promote renewable electricity was being supplemented by a commitment to feed‐in tariffs. A focus upon the evolution of ideas, combined with an appreciation for timing, continues to provide the explanation for the development of renewable electricity policy in Ontario.
“Getting the Word Out”: Policy Bloggers Use Their Soap Box to Make Change
Authors: McKenna Laura
Published: June 2007

This study examines policy bloggers, a subset of the political blogosphere. These bloggers focus on one policy area and attempt to “get the word out” concerning the importance of their policy area and policy recommendations. Information was gathered from in‐depth interviews with nine policy bloggers and content analysis of their blogs during the summer of 2006. Findings show that policy bloggers engage in six activities on their blog: filtering information, providing expertise, forming networks, gaining attention, framing arguments, and using windows of opportunity. They rarely urge their readers to partake in political activity. Nearly all received attention from major media sources, and some gained a significant daily readership. Despite these victories, their blogs were primarily labors of love, bringing in little money or professional rewards.
Innovations in the Development and Application of Edible Coatings for Fresh and Minimally Processed Fruits and Vegetables
Authors: Lin Daniel , Zhao Yanyun
Published: June 2007

ABSTRACT:  One of the major growth segments in the food retail industry is fresh and minimally processed fruits and vegetables. This new market trend has thus increased the demands to the food industry for seeking new strategies to increase storability and shelf life and to enhance microbial safety of fresh produce. The technology of edible coatings has been considered as one of the potential approaches for meeting this demand. Edible coatings from renewable sources, including lipids, polysaccharides, and proteins, can function as barriers to water vapor, gases, and other solutes and also as carriers of many functional ingredients, such as antimicrobial and antioxidant agents, thus enhancing quality and extending shelf life of fresh and minimally processed fruits and vegetables. This review discusses the rationale of using edible coatings on fresh and minimally processed produce, the challenges in developing effective coatings that meet the specific criteria of fruits and vegetables, the recent advances in the development of coating technology, the analytical techniques for measuring some important coating functionalities, and future research needs for supporting a broad range of commercial applications.
The International Quotidian Dialysis Registry: Annual Report 2007
Authors: NESRALLAH Gihad E. , SURI Rita S. , CARTER Shannon T. , MOIST Louise M. , GARG Amit X. , AWARAJI Christian , LINDSAY Robert M.
Published: June 2007

In view of the need to study both intermediate and definitive outcomes associated with daily and extended‐hours hemodialysis (HD), our group has undertaken the design and implementation of an international registry to collect data describing the treatments and outcomes of patients treated with these regimens. The International Quotidian Dialysis Registry began recruiting patients in June 2004. There are currently 229 patients enrolled in the registry, up from 199 last year. The projected growth is 2000 patients by 2008. This paper constitutes the third annual report of progress of patient and center recruitment, and includes descriptive data drawn from the 3 primary patient groups currently tracked by the registry: home nocturnal, home short‐daily, and in‐center short‐daily HD. As the cohort grows, patients will be compared with control subjects drawn from their respective national registries, and comparative analyses will follow.
Hepatitis C virus infection in dialysis patients
Authors: SUŁOWICZ Władysław , RADZISZEWSKI Andrzej , CHOWANIEC Eve
Published: June 2007

Hepatitis C virus (HCV) infection is a global health problem, common worldwide, leading to acute and chronic hepatitis and its consequences of hepatocirrhosis and hepatocellular carcinoma. Patients on hemodialysis belong to the high‐risk group of HCV infection. The prevalence of HCV infection in dialysis patients ranges from 4% to more than 70% in some countries. The main reasons for such a high incidence of infections are a high prevalence of HCV infection in the general population, lack of standard infection precautions and effective vaccination, inadequate disinfection procedures of dialysis machines and other medical equipment, as well as spread of infection from patient to patient, especially in dialytic centers with a high percentage of infected patients. The diagnostic procedures useful in the evaluation of HCV infection are detection of anti‐HCV antibodies, identification of HCV RNA, counts of virus copies, and identification of its genome. From the 6 major genotypes and multiple subtypes of the HCV, genotypes 1a and 1b are the most common in Europe and Japan, and 1b is responsible for more severe liver disease and aggressive course leading to liver fibrosis. Antiviral therapy of HCV+ dialysis patients with interferon‐α (INF‐α) gives slightly better results than in the general population, but is poorly tolerated and associated with side effects. Although ribavirin in not recommended for dialysis patients, the addition of small doses of this compound to pegylated INF is discussed, especially for patients in whom previous infection treatment failed.
Changes in hemoglobin and albumin concentration during nocturnal home hemodialysis
Authors: AGAR John W. M. , PIERRATOS Andreas
Published: June 2007

The hemoglobin (Hb) and the serum albumin (S.Alb) concentration commonly rise during seated, conventional thrice‐weekly 4 to 4.5 hr hemodialysis (CHD) as a result of rapid fluid removal from the intravascular compartment. Conversely, in long, slow, recumbent nocturnal home hemodialysis (NHHD), the intra‐dialytic S.Alb concentration has been shown to fall. In normal human physiology, plasma volume expansion rapidly follows recumbency and is sustained until a resumption of an upright position re‐induces plasma volume contraction. The plasma protein dilution of recumbency has been suggested as the mechanism behind this finding in NHHD. Our retrospective analysis of 585 consecutive measurements of predialysis and postdialysis S.Alb and Hb taken from 71 NHHD patients confirmed an intra‐dialytic fall in S.Alb (0.99% in alternate night NHHD and 1.4% in 6 nights/week NHHD) compared with an 8.4% rise in a control group of 104 CHD patients (p<0.001). Although the NHHD intra‐dialytic Hb rose (3.8% in alternate night NHHD and 2.6% in 6 nights/week NHHD), this rise was significantly greater (8%) in CHD patients (p<0.001), and as physiological data confirm that recumbent dilution for albumin is greater than that for Hb, this may provide the explanation. We conclude that NHHD provides a more physiological volume milieu with the normal physiological dilution mechanisms of recumbency still operating despite the slow, steady volume reduction that accompanied longer hour and more frequent dialysis. These mechanisms are subverted, however, in CHD by the more‐aggressive plasma contraction needed to attain adequate control of the intravascular volume in the face of shorter hour, less‐frequent dialysis.
Subcortical cognitive impairment in dialysis patients
Authors: PEREIRA Arema A. , WEINER Daniel E. , SCOTT Tammy , CHANDRA Priya , BLUESTEIN Robyn , GRIFFITH John , SARNAK Mark J.
Published: June 2007

Given the high burden of atherosclerotic cardiovascular disease in dialysis patients, we hypothesized that cognitive testing would reveal subtle abnormalities in subcortical brain function, a measure frequently associated with cerebrovascular disease. Detailed neurocognitive testing was performed in 25 hemodialysis patients. All patients had Mini‐Mental State Examination (MMSE) scores >24 and had no history of cerebrovascular disease. Where appropriate, scores were normalized for age, gender, and education. One‐sample t tests were used to compare differences in cognitive function between dialysis patients and normative data. The mean age was 57 years, and the mean MMSE was 27.5. Fourteen subjects (56%) were females, and 15 white (60%). Results of the North American Adult Reading Test, a measure of verbal intelligence, were comparable with the general population. Similarly, measures of cortical function, namely retention and recognition scores from the Word List Learning subtest of the Wechsler Memory Scale‐III, were preserved when compared with normative data where reference = 10. Significant deficits were seen on tests assessing subcortical function: scores (mean±standard deviation) for block design, and symbol coding subtests of the Wechsler Adult Intelligence Scale‐III were 7.0±1.7 and 7.7±3.1, respectively (p<0.001 for both comparisons with normative data). Similarly, adjusted scores on the trails A and B tests were 40.5±8.3 and 41.8±11.3, respectively (p<0.001 for both comparisons with normative data where reference= 50). These results suggest that, despite relatively normal MMSE scores, mild cognitive impairment may be prevalent in hemodialysis patients. The pattern of cognitive dysfunction is primarily subcortical in nature.
Internet use by end‐stage renal disease patients
Authors: SETO Emily , CAFAZZO Joseph A. , RIZO Carlos , BONERT Michael , FONG Edwin , CHAN Christopher T.
Published: June 2007

Information on the prevalence and predictors of use of the Internet by patients can be applied to the design and promotion of healthcare Internet technologies. To our knowledge, few studies on Internet use by end‐stage renal disease (ESRD) patients have been reported. The objectives of this study are to ascertain the prevalence and predictors of Internet use by ESRD patients among different dialysis modalities. A questionnaire surveying Internet use was delivered in person to 199 conventional hemodialysis patients (57 returned), and mailed to 170 peritoneal dialysis (PD) patients (42 returned), and 65 nocturnal home hemodialysis (NHD) patients (43 returned). Of the respondents, most (58%) have used the Internet to find information on their health condition. The strong majority (76%) of these patients have easy access to the Internet. A higher proportion of NHD patients (86%) used the Internet compared with the PD patients (60%) (p=0.02). Internet use was found to be more prevalent with younger (p<0.001), more educated (p=0.001), and Canadian‐born patients (p=0.005). The high prevalence of Internet use and easy access to the Internet by ESRD patients suggest that future Internet information and communication systems for healthcare management in ESRD will likely be well adopted by this patient population.
Exceeding hemoglobin target levels in US hemodialysis patients receiving epoetin, 1999 to 2002
Authors: FOLEY Robert N. , ZHANG Rui , GILBERTSON David T. , DUNNING Stephan , ISHANI Areef , COLLINS Allan J.
Published: June 2007

Despite emerging concerns that exceeding anemia targets with erythropoiesis stimulating agents may be risky for hemodialysis patients, the magnitude of and risk factors for the problem have received little attention, particularly regarding year‐to‐year comparisons. We studied monthly hemoglobin and epoetin levels in 41,101 patients aged at least 65 years who initiated hemodialysis between 1999 and 2002, with upper targets defined by hemoglobin levels of 120 and 130 g/L, respectively. While baseline hemoglobin values and epoetin doses rose from year to year, their rates of change during follow‐up declined (p<0.0001). Similar patterns were seen after reaching hemoglobin levels of 110 g/L; comparing 1999 to 2002, the proportions reaching 120 and 130 g/L in the ensuing 9 months increased from 90% to 96% (p<0.0001) and from 56% to 69%, respectively (p<0.0001). Multivariate analysis showed that, while more recent years of dialysis inception and initial epoetin dose were associated with all 3 outcomes, higher baseline hemoglobin levels were associated with reaching levels of 110 and 120 g/L, but not 130 g/L. Exceeding hemoglobin level targets has become widespread in the United States and is associated with changes in epoetin dosing practices.
The AC Conductivity of Liquid‐Phase‐Sintered Silicon Carbide
Authors: Sauti Godfrey , Can Antoinette , McLachlan David S. , Herrmann Mathias
Published: June 2007

Analysis of the AC conductivity, complex dielectric constant, and the resulting immittance spectra of liquid‐phase‐sintered silicon carbide (SiC) ceramics showed that for this system, the dominant experimental observations are due to a multicomponent grain‐boundary phase and not due to SiC grains. This is confirmed by noting that the temperature dependence of the conductivity of the components, derived from the impedance spectra, is proportional to exp[−(T0/T)1/4] and not to exp[−C/T]. The electrical properties of some of the grain boundaries are also found to be excitation voltage dependent. Combining the electrical results, which are also found to depend on the method of preparation and heat treatment, with a Rietveld analysis allows the composition of the grain boundaries of the models to be deduced.
Modified Phase Diagram for the Barium Oxide–Titanium Dioxide System for the Ferroelectric Barium Titanate
Authors: Lee Soonil , Randall Clive A. , Liu Zi‐Kui
Published: June 2007

The ferroelectric phase transition behavior in BaTiO3 was investigated for various annealing times, temperatures, and Ba/Ti ratios by means of a differential scanning calorimeter. Coupling these observations with powder X‐ray diffraction and transmission electron microscopy allowed new insights into the barium oxide (BaO)–titanium dioxide (TiO2) phase diagram. The transition temperature was varied systematically with the Ba/Ti ratio at annealing temperatures from 1200° to 1400°C in air. The transition temperature decreased with increasing concentrations of BaO and TiO2 partial Schottky defects, and showed a discontinuous change at the phase boundaries. Beyond the solubility region, two peritectoid reactions were confirmed and revised; first around 1150°C for Ba1.054Ti0.946O2.946→Ba2TiO4+BaTiO3 and second 1250°C for BaTi2O5→Ba6Ti17O40+BaTiO3, respectively. All other regimes of the BaO–TiO2 were found to be consistent with the reported diagrams in the literature.
A Co‐precipitation Technique of Preparing LaNbO4 Powders
Authors: Gupta U. N. , Pradhan Sivaram , Muthurajan H. , Kumar H. H. , Kharat D. K. , Ravi V.
Published: June 2007

A simple co‐precipitation technique was successfully used for the preparation of pure ultra fine, single‐phase LaNbO4 (LN). Aqueous sodium hydroxide was used to precipitate La3+ and Nb5+ cations as hydroxides simultaneously under basic conditions. For comparison, LN powders were also prepared by the traditional solid‐state method. It is observed that the co‐precipitation technique produces LaNbO4 on heating at temperatures as low as ∼300°C, whereas complete phase formation occurs only at 900°C or higher in the solid‐state method. The phase contents and lattice parameters were studied using powder X‐ray diffraction (XRD). The XRD results show that phases obtained by both methods were different. The average particle size and morphology of these powders were analyzed by scanning electron microscope.
Microstructure and Photoluminescence Properties of Mg‐Doped BaTiO3:Pr3+ Phosphor
Authors: Fukuda Daisuke , Takebe Hiromichi , Kuwabara Makoto
Published: June 2007

The photoluminescence of Mg‐doped BaTiO3:Pr3+ (Pr3+: 0.1 mol%) ceramics was investigated by changing the doping concentration of Mg and the sintering temperature. The results indicated that the intensity of red emission due to the 1D2→3H4 transition of Pr3+ exhibited significant dependence on both the Mg doping content and the sintering temperature; the strongest red emission intensity was observed for 2.0 mol% Mg‐doped ceramics sintered at 1050°C. An interpretation of the results obtained was made in terms of the changes in the crystal structure and microstructure of the ceramics.
Topochemical Synthesis of a High‐Aspect‐Ratio Platelet NaNbO3 Template
Authors: Yan Yongke , Liu Dan , Zhao Wei , Zhou Heping , Fang Hui
Published: June 2007

A high‐aspect‐ratio platelet sodium niobate (NaNbO3) was synthesized by a topochemical reaction. Plate‐like layered‐perovskite Bi2.5Na3.5Nb5O18 (BNN5) as a precursor was first prepared, and then Bi3+ in the precursor phase was replaced by Na+ through topotactic conversion and perovskite NaNbO3 formed at 950°C in NaCl molten salt. NaNbO3 crystals had an average length of 15 μm and a thickness of 0.5 μm. Scanning electron microscope and high‐resolution transmission electron microscope analyses indicated that the retro‐synthesis process of the desired perovskite NaNbO3 retained the morphological and structural features of the BNN5 precursor. It may be possible to synthesize other perovskite‐structured templates using the same method.
Dynamic Failure of Borosilicate Glass Under Compression/Shear Loading Experiments
Authors: Nie Xu , Chen Weinong W. , Sun Xin , Templeton Douglas W.
Published: June 2007

Dynamic compression/shear experiments on a borosilicate glass at an average strain rate of 250 s−1are conducted using a modified version of a split Hopkinson pressure bar. Instead of applying confining pressure, cuboid specimens with the material axis inclining to the loading direction at different angles (0°, 3°, 5°, and 7°) are used to generate higher shear stresses. A high‐speed digital camera, synchronized with the loading stress pulse, is used to record the dynamic crack initiation and propagation. Experimental results show that the equivalent stress at failure decreases with increasing shear portion in the stress. Digital images show that the cracks initiate randomly in the right specimen, whereas cracks initiate from the stress‐concentrated corners in the inclined specimens. Subsequent crack propagation, despite specimen inclination angles, is along the specimen axis rather than the compressive loading direction.
Distribution patterns of the Q and B biotypes of Bemisia tabaci in the Mediterranean Basin based on microsatellite variation
Authors: Simón B. , Cenis J. L. , De La Rúa P.
Published: June 2007

At least five of the biotypes described in the Bemisia tabaci (Gennadius) (Homoptera: Aleyrodidae) complex are known to be present in the Mediterranean Basin area. Only two of them, however, are economically relevant, that is, biotypes B and Q. Biological and genetic differences between the two biotypes have been well studied, but less is known about their patterns of genetic variation and population structure. To address these issues, a study was undertaken based on variation at six microsatellite loci among a subset of nine B. tabaci populations (five belonging to the Q and four to the B biotype). The data obtained show that (i) these loci showed considerable polymorphism in the Q and B biotypes populations although the presence of null alleles can obscure the picture; (ii) the Iberian‐Q, Canarian‐Q, and Egyptian‐B populations exhibit heterozygosity excess as a result of bottleneck events; (iii) the low genetic differentiation between the Israeli, Iberian Peninsula, and Italian populations suggest that these populations share a common gene pool; (iv) the genetic distances between the Canarian‐Q population and the geographically close population from Morocco indicates spatial isolation and a limited gene flow; and finally (v) the microsatellite data for the B populations indicate that the whiteflies from Egypt and Israel have a close phylogenetic relationship, but the source of these biotype B invasions into the Mediterranean area remains unknown.
Effect of intravitreal injections and volume changes on intraocular pressure: clinical results and biomechanical model
Authors: Kotliar Konstantin , Maier Mathias , Bauer Svetlana , Feucht Nikolaus , Lohmann Chris , Lanzl Ines
Published: June 2007

Purpose:  Intravitreal injections are used extensively to treat retinal diseases. Performing an intravitreal injection increases intraocular volume by the amount of fluid brought into the eye. Whether this influences intraocular pressure (IOP) was investigated here.

Methods:  A biomechanical model relying on 3‐dimensional elasticity theory was developed to determine the short‐term effect of volume changes on IOP. We calculated the effect for intravitreal injections of 0.1 ml in myopic, emmetropic and hyperopic eyes. Our calculations were compared with IOP measurements obtained immediately after intravitreal injection of 4 mg triamcinolone in 0.1 ml solution (IVTA) in 22 patients. Shortly after the measurement had been taken, IOP was reduced by paracentesis.

Results:  Immediately after IVTA, measured IOP was elevated by a mean of 40.6 ± 12.1 mmHg compared with initial pressure (p < 0.001). Measured and calculated IOP were comparable. Eyes with shorter axial length had higher IOP immediately after the injection (p < 0.05).

Conclusions:  The effect of injected volumes on IOP can be calculated with a biomechanical model. Our results show that paracentesis might be recommended when injecting 0.1 ml of a substance to avoid a short‐term increase in IOP. As intravitreal injections are mostly applied in diseases that are due to vascular compromise, it might be prudent not to impair perfusion in those eyes, even for short periods of time.
Changes in dental status and dental care utilization in the Swedish population over three decades: age, period, or cohort effects?
Authors: Ahacic Kozma , Thorslund Mats
Published: June 2007

Abstract –  Objectives:  In cross‐sectional data, cohort effects give a false impression of changes in edentulousness over age and time. This study, therefore, corroborated cross‐sectional data with corresponding longitudinal analyses. Complete or partial edentulousness and yearly dental care utilization were studied from 1968 to 2002.

Methods:  A nationally representative Swedish panel study allowed repeated cross‐sectional comparisons of ages 18–75 (5 waves n ≈ 5000), and ages 77+ at later waves (2 waves n ≈ 500). Cross‐sectional 10‐year age group differences in 5 waves, time‐lag differences between waves for age groups, and within‐cohort differences between waves for 10‐year birth cohorts were examined.

Results:  Regular over time analysis revealed large decreases in edentulousness between waves. While cross‐sectional differences indicated an exponential curve‐linear age‐dependency, longitudinal differences revealed little decline, contradicting cross‐sectional results. Following the cohorts showed little change within cohorts but large differences between cohorts. Care utilization increased between 1968 and 2002 in older age groups but decreased somewhat in younger ones. In 1968, utilization was highly age‐related with lower utilization rates among older age groups. By 2000/2002, this had almost reversed. However, all cohorts had aged with little change in their rates of care utilization, while at the same time great between‐cohort differences were demonstrated.

Conclusions:  For both edentulousness and dental care utilization, almost all variation originated before 1968. These cohort effects are probably the consequences of changes in dentistry going back several decades and they demonstrate the early socialization of health behavior.
Baboon syndrome induced by mercury – first case report in China
Authors: Wen Liping , Yin Jia , Ma Dong‐Lai , Lanier Bob
Published: June 2007

A case of mercury‐induced baboon syndrome was reported. A 31‐year‐old woman presented with itching papules and vesicles in the right axilla, which extended to the left axilla, arms, fossa poplitea, buttocks, and groin. A mercury thermometer was broken 2 days before exanthema. Patch testing to ammoniated mercury, mercury, mercuric chloride, and mercurochrome were positive. Blood and urine mercury level was marginally normal, yet showed a descending trend over time.
Allergic contact dermatitis from Laurus nobilis oil induced by massage
Authors: Adişen Esra , Önder Meltem
Published: June 2007

Non‐occupational contact allergy to Laurus nobilis (laurel) oil is considered rare. Herein, we report a case of allergic contact dermatitis after a massage with a mixture of olive oil and L. nobilis oil. Patch testing showed (+++) reactions to laurel oil and (++) to the mixture of olive oil and laurel oil.
Contact dermatitis with clostridiopeptidase A contained in Noruxol® ointment
Authors: Foti Caterina , Conserva Anna , Casulli Claudia , Scrimieri Valentina , Pepe Maria Luisa , Quaranta Domenico
Published: June 2007

Clostridiopeptidase A, also called collagenase 1, is a proteolytic enzyme capable of digesting collagen. Preparations containing clostridiopeptidase A are used topically for the debridement of dermal ulcers, burns and other necrotic lesions to facilitate the formation of granulation tissue and subsequent epithelization. We observed 4 patients with a periulcerative eczema after repeated applications of Noruxol® ointment (Smith & Nephew Ltd, L Hull, UK). Patch testing with Noruxol® ointment as is and its excipients (soft paraffin and white petrolatum), as well as scaled dilutions of the main ingredient of this topical preparation, clostridiopeptidase A (Firma, Florence, Italy), showed doubtful reactions to Noruxol® ointment in 3 patients and a positive reactions only in 1 patient. All patients showed positive reactions to clostridiopeptidase A 1% in pet. This study shows the sensitizing capacity of clostridiopeptidase A that should be tested in all patients with suspect sensitization to Noruxol® ointment.
Proactive surveillance of contact allergies: an important component of the risk management strategy for skin sensitizers
Authors: Jowsey Ian R.
Published: June 2007

Risk assessment serves to ensure that dermal exposure to skin sensitizers does not result in the acquisition of allergic skin disease. Traditionally, the approach adopted was one of comparative analysis, involving benchmarking against other allergens of known potency. More recently, efforts have been made to embrace a quantitative risk assessment (QRA) approach. However, the accuracy of any risk assessment is reflected in the extent to which it meets the fundamental objective stated above. Thus, clinical experience is of key importance. There exists the possibility for the originators of risk assessments relating to chemicals that possess skin‐sensitizing potential to work directly with the clinical community to proactively obtain this experience through specific surveillance programmes. This forms the focus of this review article. The current status of the QRA approach is considered initially. A recently published example of one such surveillance programme that was undertaken as a collaborative initiative between industry and the clinical community is then reviewed. Finally, a possible strategy for the future is presented, in which it is suggested that surveillance strategies might be deployed in certain situations as an adjunct to the initial risk assessment. It is hoped that such a framework might further improve the efficacy of future approaches to skin sensitization risk assessment.
Sensitization to 26 fragrances to be labelled according to current European regulation
Authors: Schnuch Axel , Uter Wolfgang , Geier Johannes , Lessmann Holger , Frosch Peter J
Published: June 2007

To study the frequency of sensitization to 26 fragrances to be labelled according to current European regulation. During 4 periods of 6 months, from 1 January 2003 to 31 December 2004, 26 fragrances were patch tested additionally to the standard series in a total of 21 325 patients; the number of patients tested with each of the fragrances ranged from 1658 to 4238. Hydroxymethylpentylcyclohexene carboxaldehyde (HMPCC) was tested throughout all periods. The following frequencies of sensitization (rates in %, standardized for sex and age) were observed: tree moss (2.4%), HMPCC (2.3), oak moss (2.0), hydroxycitronellal (1.3), isoeugenol (1.1), cinnamic aldehyde (1.0), farnesol (0.9), cinnamic alcohol (0.6), citral (0.6), citronellol (0.5), geraniol (0.4), eugenol (0.4), coumarin (0.4), lilial (0.3), amyl‐cinnamic alcohol (0.3), benzyl cinnamate (0.3), benzyl alcohol (0.3), linalool (0.2), methylheptin carbonate (0.2), amyl‐cinnamic aldehyde (0.1), hexyl‐cinnamic aldehyde (0.1), limonene (0.1), benzyl salicylate (0.1), γ‐methylionon (0.1), benzyl benzoate (0.0), anisyl alcohol (0.0). 1) Substances with higher sensitization frequencies were characterized by a considerable number of ‘++/+++’ reactions. 2) Substances with low sensitization frequencies were characterized by a high number of doubtful/irritant and a low number of stronger (++/+++) reactions. 3) There are obviously fragrances among the 26 which are, with regard to contact allergy, of great, others of minor, and some of no importance at all.
Occupational contact dermatitis in Australia: diagnostic and management practices, and severity of worker impairment
Authors: Keegel Tessa , Erbas Bircan , Cahill Jennifer , Noonan Amanda , Dharmage Shyamali , Nixon Rosemary
Published: June 2007

The aims of this study were to compare treatment and referral practices between general practitioners (GPs) and dermatologists and to evaluate predictors for occupational contact dermatitis (OCD) disease severity measured in terms of worker impairment. Data were collected from 181 patients recruited for a larger study of OCD. Information about treatment recommendations and usual referral practices are reported for 123 patients. Data from patients, diagnosed with work‐related skin disease, were modelled for severity of worker impairment. GPs were more likely to treat a patient independently, referring if the patient did not improve, whereas dermatologists were more likely to refer for patch testing on initial presentation. Dermatologists were more likely to recommend gloves and GPs were more likely to recommend soap avoidance/substitution. 2 GPs and no dermatologists reported recommending the best practice combination of moisturizers, topical corticosteroids and soap substitutes. When adjusted for all variables including age, sex, duration and diagnostic subgroup, workers with atopy as a cofactor had the most severe impairment. This study suggests that in Australia, patients with suspected OCD are initially managed within general practice, few clinicians recommend best practice treatments for OCD, and that atopy is associated with severity. These findings have implications for health resource allocation, clinician education, and the pre‐employment counselling of atopic patients.
Nickel release from nickel particles in artificial sweat
Authors: Midander Klara , Pan Jinshan , Wallinder Inger Odnevall , Heim Katherine , Leygraf Christofer
Published: June 2007

Nickel is widely used in a broad range of products, primarily made of alloys, used by humans on a daily basis. Previous assessments have shown that skin contact with some such products may cause nickel allergic contact dermatitis, induced by the release of nickel. However, data on nickel release from small nickel particles in artificial sweat for assessment of potential risks of workers in nickel‐producing and nickel‐using facilities are not available. The objective of this study was to fill this knowledge gap by determining nickel release from fine nickel powder (∼4 μm diameter) of different loadings varying from 0.1 to 5 mg/cm2, when immersed in artificial sweat. The amount of nickel released increased with increasing particle loading, whereas the highest release rate per surface area of particles was observed for the medium particle loading, 1 mg/cm2, at current experimental conditions. All particle loadings showed time‐dependent release rates, reaching a relative steady‐state level of less than 0.1 μg/cm2/hr after 12 hr of immersion, whereby less than 0.5% of the nickel particle loading was released. Nickel release from particles was influenced by the surface composition, the active surface area for corrosion, particle size, and loading.
Unexpected sensitization routes and general frequency of contact allergies in an elderly stented Swedish population
Authors: Cecilia Svedman , Susanne Ekqvist , Halvor Möller , Jonas Björk , Birgitta Gruvberger , Eva Holmström , Magnus Bruze
Published: June 2007

Contact allergy to stent material has been proposed to be a risk factor for restenosis, after percutaneous transluminal coronary angioplasty (PTCA) and stenting. Information on the general frequency of contact allergy in the elderly population is scarce and knowledge of possible sensitization routes is important to investigate. The aim of this study was to investigate contact allergy to stent materials and other allergens. Here we report our findings on the frequency of contact allergies apart from those from stent material. In this retrospective study, we patch tested an elderly population, treated with PTCA and stented, with our standard series. A dermatitis population served as controls. We found a high frequency of contact allergy in both groups but a greater ‘contact allergy burden’, with generally higher frequencies for contact allergens, in the dermatitis patients as expected. Myroxylon pereirae and caine mix were apart from metals exceptions with statistically significant higher frequencies (P < 0.01) for the stented patients. Contact allergy to nonmetal sensitizers is common in an elderly Swedish stent population although, on the whole, substantially less than in an age and sex‐matched dermatitis population. The findings indicate the importance of the oral mucosa for sensitization. In a general population that has been treated with a special medication/treatment procedure, contact allergies not suspected (such as to M. pereirae and to the metals) might suddenly peak. This underlines the importance of a careful evaluation of new products and routines with regard to contact allergies in the population.
Evaluation of barrier creams – introduction and comparison of 3 in vivo methods
Authors: Rieger Tina , Teichmann Alexa , Richter Heike , Schanzer Sabine , Sterry Wolfram , Lademann Jürgen
Published: June 2007

Often barrier creams (BC) do not fulfil their protecting behaviour, even when promised by the manufacturers. Therefore, it is of great importance to develop standardized in vivo techniques to prove the potency of BC in humans. In the present study, 3 promising techniques for the analysis of BC were evaluated: laser scanning microscopy, laser doppler flowmetry, and the tape‐stripping procedure. Sodium fluorescein and glycerol trinitrate acted as hydrophilic model‐penetrating substances. By means of these methods, 3 different BC were tested and compared for their potency. The investigations showed that primarily the tape‐stripping procedure and also the laser scanning microscopy are promising tools for the evaluation of BC. In contrast, the laser doppler flowmetry represents a less feasible technique. In addition, the evaluation of BC showed that Vaseline enfolds a 100% barrier on the skin surface for the penetration of a hydrophilic dye, whereas BC1 only partially showed a protective effect and BC2 exhibited almost no potency. In conclusion, it can be referred that laser scanning microscopy and the tape‐stripping procedure represent 2 non‐invasive in vivo techniques, which enable a fast investigation concerning the potency of BC.
Tixocortol pivalate: what is the right concentration?
Authors: Kalavala Manjunatha , Statham Barry N. , Green Cathy M. , King Clodagh , Ormerod Anthony D. , Sansom Jane , English John S. C. , Wilkinson Mark S. , Horne Helen , Gawkrodger David
Published: June 2007

Tixocortol pivalate (TP) is a good marker for hydrocortisone allergy. The concentration of TP to be included in the standard series for patch testing has been the subject of debate. The objective of this study was to investigate the right concentration of TP to be included in the standard series for patch testing. 3747 consecutive patients with dermatitis were patch tested simultaneously with TP 1% and 0.1% in petrolatum at 9 centres in the UK from August 2004 to December 2005. Statistical analysis of the results was performed using Statistica, version 6 software. 41 patients had positive reactions of current or past relevance. 20 were positive for both concentrations, 13 positive only for TP 1% concentration, and 8 positive only for 0.1% concentration. Statistical analysis, using a two‐tailed difference in proportions test, did not show a significant difference between the 2 concentrations (P = 0.21). There was no statistically significant difference between the 2 concentrations of TP. The number of allergens that can be included in the standard series is limited for practical considerations. When testing for screening purposes, TP 1% is recommended.
Patch test reactivity to a cobalt–chromium–molybdenum alloy and stainless steel in metal‐allergic patients in correlation to the metal ion release
Authors: Summer Burkhard , Fink Ulrich , Zeller Richard , Rueff Franziska , Maier Sonja , Roider Gabriele , Thomas Peter
Published: June 2007

Nickel, chromium, and cobalt released from stainless steel and CoCrMo alloys have been postulated to trigger hypersensitivity reactions. The objective of this study was to assess the ion release from a CoCrMo alloy and stainless steel in vitro and the cutaneous reactivity to it by patch test. 52 metal‐allergic patients and 48 non‐allergic controls were patch tested to stainless steel and CoCrMo discs. In addition, using atomic absorption spectrometry, the release of nickel, cobalt, and chromium from both materials was assessed upon 2‐day exposure to distilled water, artificial sweat (AS), and cell culture medium. There was low nickel ion release from stainless steel (0.3–0.46 μg/cm2/2 days) and CoCrMo discs (up to 0.33 μg/cm2/2 days) into the different elution media. Chromium release from the 2 materials was also very low (0.06–0.38 μg/cm2/2 days from stainless steel and 0.52–1.36 μg/cm2/2 days from CoCrMo alloy). In contrast, AS led to abundant cobalt release (maximally 18.94 μg/cm2/2 days) from the CoCrMo discs, with concomitant eczematous reaction upon patch testing: 0 of the 52 metal‐allergic patients reacted to stainless steel discs and 5 of the 52 patients to CoCrMo discs (all 5 patients were cobalt allergic and 3 also nickel and chromium allergic). None of the controls reacted to the discs. Apart from nickel being a focus of allergological research, our results point to the possibly underestimated association of cobalt release and potential hyperreactivity to CoCrMo alloy.
Contact dermatitis in tobacco farmworkers
Authors: Abraham Nina F. , Feldman Steven R. , Vallejos Quirina , Whalley Lara E. , Brooks Thanh , Cabral Gonzalo , Earp Patricia , Fleischer Alan B , Quandt Sara A. , Arcury Thomas A.
Published: June 2007

Occupational skin disease is highly prevalent among agricultural workers. Tobacco cultivation and harvest are particularly hazardous for farmworkers. We report 5 migrant Latino farmworkers in North Carolina with contact dermatitis related to tobacco work. These cases show a characteristic distribution of contact dermatitis; the flexural and medial surfaces of the upper extremities were affected in each case, whereas most cases showed some involvement of the torso and axilla. This pattern most likely reflects a common occupational practice of holding the tobacco leaves under the arm and pressed against the body during harvesting.
Contact allergy to acrylates/methacrylates in the acrylate and nail acrylics series in southern Sweden: simultaneous positive patch test reaction patterns and possible screening allergens
Authors: Teik‐Jin Goon Anthony , Bruze Magnus , Zimerson Erik , Goh Chee‐Leok , Isaksson Marléne
Published: June 2007

In a recent study we showed that all our dental personnel/patients were detected with 2‐hydroxyethyl methacrylate (2‐HEMA) and 2,2‐bis[4‐(2‐hydroxy‐3‐methacryloxypropoxy)phenyl]propane (bis‐GMA). We studied 90 patients tested to the acrylate and nail acrylics series at our department over a 10 year period to see whether screening allergens could be found. Patch testing with an acrylate and nail acrylics series was performed. Among the 10 acrylate/methacrylate‐allergic occupational dermatitis patients tested to the acrylate series, the most common allergens were triethyleneglycol diacrylate (TREGDA, 8), diethyleneglycol diacrylate (5), and 1,4‐butanediol diacrylate (BUDA, 5). All 10 of these patients would have been picked up by a short screening series combining TREGDA, 2‐hydroxypropyl methacrylate (2‐HPMA), and BUDA or 1,6‐hexanediol diacrylate (HDDA). Among the 14 acrylate/methacrylate‐allergic nail patients, the most common allergens were ethylene glycol dimethacrylate (EGDMA, 11), 2‐HEMA, (9), and triethyleneglycol dimethacrylate (9). Screening for 3 allergens i.e. 2‐HEMA plus EGDMA plus TREGDA, would have detected all 14 nail patients. A short screening series combining 2‐HEMA, EGDMA, TREGDA, 2‐HPMA, bis‐GMA, and BUDA or HDDA would have picked up all our past study patients (dental, industrial, and nail) with suspected allergy to acrylate/methacrylate allergens.
Cytokine and chemokine release upon prolonged mechanical loading of the epidermis
Authors: Bronneberg Debbie , Spiekstra Sander W. , Cornelissen Lisette H. , Oomens Cees W. J. , Gibbs Susan , Baaijens Frank P. T. , Bouten Catlijin V. C.
Published: June 2007

Abstract:  At this moment, pressure ulcer risk assessment is dominated by subjective measures and does not predict pressure ulcer development satisfactorily. Objective measures are, therefore, needed for an early detection of these ulcers. The current in vitro study evaluates cytokines and chemokines [interleukin 1α (IL‐1α), interleukin 1 receptor antagonist (IL‐1RA), tumor necrosis factor α (TNF‐α) and interleukin 8 (CXCL8/IL‐8)] as early markers for mechanically‐induced epidermal damage. Various degrees of epidermal damage were induced by subjecting commercially available epidermal equivalents (EpiDerm) to increasing pressures (0, 50, 75, 100, 150, and 200 mmHg) for 24 h, using a loading device. At the end of the loading experiment, tissue damage was assessed by histological examination and by evaluation of the cell membrane integrity. Cytokines and chemokines were determined in the culture supernatant. Sustained epidermal loading resulted in an increased release of IL‐1α, IL‐1RA, TNF‐α and CXCL8/IL‐8. This was first observed at 75 mmHg, when the tissue was only slightly damaged. Swollen cells, vacuoles, necrosis and affected cell membranes were observed at pressures higher than 75 mmHg. Furthermore, at 150 and 200 mmHg, the cells in the lower part of the epidermis were severely compressed. In conclusion, IL‐1α, IL‐1RA, TNF‐α and CXCL8/IL‐8 are released in vitro as a result of sustained mechanical loading of the epidermis. The first increase in cytokines and chemokines was observed when the epidermal tissue was only slightly damaged. Therefore, these cytokines and chemokines are potential markers for the objective, early detection of mechanically‐induced skin damage, such as pressure ulcers.