bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rethinking environmental management
Authors: Bryant Raymond L. , Wilson Geo• A. 
Published: November 2003

The field of environmental management developed as a technocentric problem-solving initiative, providing ‘practical’ assistance to state officials involved in environmental management. Since the field was largely associated with what state officials and associated experts ‘dO', little effort was devoted to understanding the political, economic or cultural forces conditioning the process of environmental management. The potentially significant contribution of diverse nonstate actors – for example, farmers, shifting cultivators, businesses or nongovernmental organizations – to this process was notably neglected. The field has recently become the target of mounting criticism with ‘environmental managerialism’ dismissed as a research agenda divorced from key issues in human–environment interaction. This article argues that a recognition of the limitations of traditional understandings of environmental management ought to serve as the basis for a rethink of this field of study. This argument is developed in two stages. The article first explores how the traditional approach understands environmental management as a state-centred process, assesses diverse problems with that understanding and sketches an alternative way of thinking about this issue. The article then assesses how environmental management as a field of study is usually understood, the pitfalls of that understanding and the possible contours of an alternative appreciation of the field of environmental management. By adopting a more inclusive understanding of what environ-mental management is as a process, a broader appreciation of the nature of environmental management as a field of study can be obtained. The article concludes that a revitalized field can overcome existing deficiencies so as to be in a position to make thereafter an important contribution to research on human–environment interaction.
Epidemiologic evidence of cancer risk in textile industry workers: a review and update
Authors: Mastrangelo Giuseppe , Fedeli Ugo , Fadda Emanuela , Milan Giovanni , Lange John H 
Published: November 2003

A meta-analysis of epidemiologic studies for textile industry workers was undertaken in an attempt to evaluate whether the cancer risk varies within the textile industry in relation to the job held or the textile fiber used. We combined studies published up until 1990, when an ad hoc IARC Monograph was issued, and those published after 1990 with the aim of appreciating evidence of reversing trends in cancer risk. Observed and expected cases reported in the original studies were summed up and the totals were divided to obtain a pooled relative risk (PRR) with a 95% confidence interval (CI) estimated with a fixed-effect model. We calculated a chi-square test (x2) of heterogeneity among studies. When PRR and x2 were both significant, PRR and CI were calculated with a random-effect model and the source of heterogeneity was investigated. Lung cancer risk was around 0.4 in the first study on cotton workers published in 1936, around 0.7 in subsequent studies, mostly published in the 1970s and 1980s, and around 1.0 in the last studies published in the 1990s. Papers published in the 1970s and 1980s produced consistent risk estimates for lung cancer risk, which was significantly lower than 1.0 in workers exposed to cotton (PRR 3/4-0.77; CI3/4-0.69-0.86) and wool dust (0.71; 0.50-0.92), as well as in carders and fiber preparers (0.73; 0.54-0.91), weavers (0.71; 0.56-0.85), and spinners and weavers (0.78; 0.66-0.91). Lung cancer PRRs did not significantly deviate from 1.0 in textile workers using synthetic fibers or silk, and in dyers. Increased PRRs were found for sinonasal cancer in workers exposed to cotton dust, and in workers involved in spinning or weaving (4.14; 1.80-6.49). PRR was 1.46 (1.10-1.82) for cancer of the digestive system in textile workers using synthetic fibers or silk, and 1.34 (1.10-1.59) for colorectal cancer in spinners and weavers. The increased bladder cancer PRR in dyers (1.39; 1.07-1.71) is generally attributed to textile dye exposure. In studies published after 1990, there is a general tendency to move toward unity for all the cancer risk estimates, leading to an increasing heterogeneity among studies. Since adjustment for smoking made little difference to the findings, the latter could be attributed to the exposure to textile dusts. The recent findings could be due to a lowering of dust concentration in the workplaces. The reduction of cases of upper respiratory tract cancer parallels with a corresponding increase of lung cancer cases. So, preventive measures have paradoxically increased the lung cancer burden to the textile workers.
A comparison of the decontamination efficacy of foam-making blends based on cationic and nonionic tensides against organophosphorus compounds determinedin vitro and in vivo
Authors: Cabal J , Kassa J , Severa J 
Published: November 2003

The ability of foam-making blends to decontaminate the skin exposed to organophosphorus compounds was tested. The appropriate composition and rheological features (stability, grade of foaming) of tested blends were evaluated by in vitro methods and their ability to remove the contaminants from hard surface and to transform the contaminants into nontoxic compounds was evaluated byin vivo methods. The blends containing cationic and nonionic tensides as well as alkalized hydrogen peroxide seem to be the most efficacious to decontaminate the skin exposed to organophosphorus compounds according to the literature data. The composition of tested blends was optimized because particular components often have antagonistic effects. Cationic tensides support the reactivity of the blend and control the grade of foaming. Nonionic tensides control the stability of the foams but also react as retardants of the reactivity of the foams. Hydrogen peroxide is a real reacting component when it is transformed into hydrogen peroxide anion. It also acts as buffer if pH is higher than 11. Our in vivo results confirm that Desam OX (34 and 68%) and the foam-making blend containing benzalkonium chloride / Althosan MB (8%), Slovasol 2510 (2%) and hydrogen peroxide (3%) alkalized at pH 12 seem to be the most efficacious to remove contaminants (soman, VX) from the skin and transform them into nontoxic compounds. Therefore they could be used for primary decontamination of chemical casualties contaminated with nerve agents in the field condition.
Evaluation of historical control data in carcinogenicity studies
Authors: Greim H , Gelbke H-P , Reuter U , Thielmann H W , Edler L 
Published: November 2003

Results obtained in long-term carcinogenicity studies with animals should be evaluated, first and foremost, by statistical comparisons of the data obtained from the treated group with that from the concurrent control group. Often the results are compared with data from so-called historical control groups in order to take variations in the incidences of spontaneous tumours into account. Because historical control data change in the course of time and for a variety of reasons, certain requirements must be met before they may be used in the evaluation of the results of long-term studies. The present paper discusses potential sources of variability of tumour incidences in untreated animals, presents databanks for historical control data, mentions the factors that affect tumour incidences in untreated animals and describes biostatistical data evaluation. Finally, details are given of the criteria used by the DFG Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area to decide whether historical control data may be applied. These include the requirement that the historical control data were obtained with animals of the same species and strain and from the same breeder. The data were obtained in the same laboratory, the study design, experimental methods and assessment criteria were the same, and the studies used for the comparison were carried out within a limited time window. Historical control data that have not been published may be used provided they fulfil the above criteria and have been made available in sufficient detail to be comprehensible.
Validation of the Chinese SF-36 for quality of life assessment in patients with systemic lupus erythematosus
Authors: Thumboo J , Feng P-H , Boey M-L , Soh C-H , Thio S-t , Fong K-Y 
Published: November 2003

We studied the reliability and validity of the Chinese Short-Form 36 Health Survey (SF-36) in a cross sectional study of patients with systemic lupus erythematosus (SLE). Sixty-nine consecutive subjects completed a questionnaire containing the Chinese SF-36 twice within 14 d. Disease activity and damage were assessed using the British Isles Lupus Activity Group (BILAG) and SLICC/ACR Damage Index (DI) scales, respectively. Internal consistency was assessed using Cronbach's alpha, reliability using Spearman's correlation and repeatability coefficients, and relationships between SF-36, BILAG and DI scores using Spearman's correlation. The Chinese SF-36 showed high internal consistency (ά =0.72– 0.91) and good reliability, with correlations exceeding 0.70 for 7 scales and mean scale score differences of < 2 points for 6 scales. SF-36 scores correlated weakly with BILAG scores (–0.27 to –0.41) and DI scores (–0.24 to –0.35), and subjects' mean SF-36 scores were 6 – 24 points lower than the general population, supporting construct validity of the SP-36. These data suggest that the Chinese SF-36 is a reliable and valid measure of quality of life in patients with SLE.
Wegener‘s granulomatosis associated with antiphospholipid syndrome
Authors: Castellino G , La Corte R , Santilli D , Trotta F 
Published: November 2003

We report a case of Wegener‘s granulomatosis (WG) with pulmonary hemorrhage also satisfying the criteria for antiphospholipid antibody syndrome (APS). This association has, to the best of our knowledge, never been described before. Pulmonary hemorrhage may be an early manifestation of several immune and idiopathic disorders such as ANCA-associated vasculitis. Several case-reports of APS patients with capillaritis have been described. A possible explanation is that microvascular thrombosis with subsequent increase in vascular permeability facilitates perivascular IgG and complement deposition leading to development of capillaritis. Whether the vascular disease is secondary to thrombosis or vasculitis or both is important in choosing the proper management strategy. We suggest that anticardiolipin antibodies (aCL) should be detected in ANCA-associated vascularitis because they may contribute to life-threatening events superimposed on vascular damage.
Systemic lupus erythematosus in three ethnic groups. VI: Factors associated with fatigue within 5 years of criteria diagnosis
Authors: Zonana-Nacach Abraham , Roseman Jeffrey M , McGwin Gerald , Friedman Alan W , Baethge Bruce A , Reveille John D 
Published: November 2003

Objective: To determine the frequency, degree and associated features of fatigue among Hispanic (H), African American (AA) and Caucasian (C) patients with recent onset (5 yr) systemic lupus erythematosus (SLE) at their baseline evaluation. Methods: H(n = 69), AA (n = 83) and C (n = 71) patients from the LUMINA (LUpus in MInority populations: NAture vs Nurture) cohort were studied. Fatigue [Fatigue Severity Scale (FSS)] was defined as present if FSS score 3.0. Variables from functional, clinical, sociodemographic, health behaviors, behavioral and psychological and immunogenetics domains were ascertained at study entry. Associations were examined using regression models. Results: Eighty-six percent (85.7%) of patients reported having fatigue (82.6% H; 85.5% AA; 88.7% C); median FSS score, 5.3. Factors from the psychological and clinical domains were primarily associated with FSS; immunogenetic (HLA Class II phenotypes) features were not. Increased fatigue was strongly associated with decreasing function, both physical and mental. Variables associated with significantly greater degree of fatigue at baseline in the multivariable stepwise model in order of decreasing additional partial R2 explained included: abnormal illnessrelated behaviors, older age, higher self-reported pain, greater degree of helplessness, greater disease activity, Caucasian race, and lacking health insurance (model R2 = 37%). Conclusions: Fatigue is one of the most prevalent clinical manifestations of SLE across all ethnic groups. The perception of fatigue severity in SLE may be multifactorial in origin, including psychosocial factors and disease activity. If these prove causal, knowledge of their contribution may suggest therapeutic and/or behavioral interventions, which could ameliorate this pervasive and often incapacitating symptom of SLE.
The benefit of combining hydroxychloroquine with quinacrine in the treatment of SLE patients
Authors: Toubi E , Rosner I , Rozenbaum M , Kessel A , Golan T D 
Published: November 2003

Background: Although the benefit of antimalarials in the treatment of cutaneous LE is well established, the effect of combined hydroxychloroquine and quinacrine treatment in systemic lupus erythematosus with major organ involvement remains underappreciated. Patients: Six active SLE patients (SLEDAI score > 5 points), with a mean duration of illness 9.1 yr (range 2 ± 17 yr) were started on quinacrine (100 mg/d) following failure to achieve clinical remission on a therapeutic regimen which included a maintenance dose of hydroxychloroquine (400 mg/d) together with prednisone (either 10 ± 20 mg/d or higher daily doses of this agent for short periods) and azathioprine (150 mg/d) or methotrexate (7.5 mg/week). Outcome: In 5=6 of the patients the addition of quinacrine to the previous treatment resulted in complete remission (SLEDAI 0 ± 2 points), which persisted over the follow-up period [mean 2.2 yr (range 0.5 ± 3.5)]. During this period hydroxychloroquine and azathioprine were reduced to 200 mg/d and 100 mg/d respectively, whereas prednisone was modified as follows: in 2 patients daily administration was discontinued; in one the dose was reduced to 2.5 mg/d (from that of 20 mg/d); in 2 others the previous need for an intermittent course was avoided. However, in one out of the six patients the addition for 3 months of quinacrine to the therapeutic protocol did not result in clinical improvement and was therefore discontinued. Conclusions: The promising results of this preliminary investigation encourages the combined use of the two antimalarial drugs in appropriate candidates. This modality may induce remission, seems to be safe and possesses a steroid sparing effect.
Anti-telomere antibodies in systemic lupus erythematosus: a new ELISA test for anti-DNA with potential pathogenetic implications
Authors: Wallace D J , Salonen E-M , Avaniss-Aghajani E , Morris R , Metzger A L , Pashinian N 
Published: November 2003

Background: Telomeric hexamer repeats (TTAGGG/CCCTAA)n are highly repetitive sequences of DNA. They cap the termini of eukaryotic chromosomes and stabilize them, preventing degradation or fusion. Anti ds-DNA is one of the most specific tests for systemic lupus erythematosus (SLE). Of related importance, a preliminary report has suggested that anti-telomere antibodies are also highly specific for the presence of SLE. Methods: 220 patients with SLE, 79 with rheumatoid arthritis (RA), 54 with other rheumatic diseases and 99 healthy controls were tested for anti-telomere antibody as measured by enzyme immunoassay detecting 30and 60-mer telomeric repeats (5 ± 10 hexamers). 48 of the 220 SLE patients charts were abstracted for 90 separate clinical, laboratory and treatment parameters. Comparisons were made between SLE and non-SLE patients, and within the lupus group for telomere positivity and among the latter 48 patients for anti-DNA (Farr) levels and SLEDAI scores. Results: Anti-telomere antibody was present in 48.6% of the overall SLE group (220), 71% of our cohort (48), 11% with primary Sjogren's (2=18), 7.6% with RA (6=79) and 2% of normal controls (2=99) (P < 0.001 comparing SLE to all other groups). In the 48 patient cohort, anti-telomere antibody was more sensitive than anti-dsDNA (Farr) (71% vs 50%), but did not correlate with other clinical parameters, SLEDAI scores, or other autoantibodies. Conclusions: The detection of anti-telomere antibody appears to be more sensitive and may be as specific as anti-dsDNA (Farr) in SLE. The detection of telomeric repeats may be as accurate as other anti-DNA assay methodologies and more specific for the presence of SLE. The immunogenic potential of telomere biology related to the pathogenesis and/or diagnosis of SLE deserves further investigation.
Primary and secondary pulmonary hypertension in systemic lupus erythematosus
Authors: Pan T Ling-Te , Thumboo J , Boey M-L 
Published: November 2003

Objectives: To describe the aetiology and clinical profile of primary and secondary pulmonary hypertension (PHT) in SLE patients. Methods: A retrospective study of SLE patients with PHT identified from a cohort of 786 SLE patients seen at Tan Tock Seng Hospital, Singapore. Results: 22 patients had primary and 24 patients had secondary PHT, with similar clinical features at presentation and a similar degree of pulmonary pressure elevation. Secondary PHT was due to valvular heart disease (50%), pulmonary embolism (13%), interstitial lung disease (8%) or a combination of these factors (29%). Primary PHT tended to present after a shorter duration of lupus than secondary PHT (8.8 vs 43.2 months, P = 0.118). At presentation, Raynaud's phenomenon was present in 34.8% of subjects with primary or secondary PHT. Among those with secondary PHT, the presence of Raynaud's phenomenon was associated with a trend towards higher pulmonary artery systolic pressures (51.0 vs 40.5 mmHg, P = 0.101). 17% of patients with PHT died, but from causes unrelated to PHT. Conclusion: Primary and secondary PHT are equally common in SLE patients. Secondary PHT is often multi-factorial, and Raynaud's phenomenon may be a marker for the severity of PHT in this group of patients.
The variation in anti-ENA characteristics between different ethnic populations with systemic lupus erythematosus over a 10-year period
Authors: Tench C M , Isenberg D A 
Published: November 2003

Objective: To assess how anti-ENA characteristics change in patients with systemic lupus erythematosus from different ethnic backgrounds over a 10-year period follow-up study. Results: There were 61 patients, of whom 37 were Caucasian, 12 were Asian and 12 were AfroCaribbean. At the first available bleed 12=37 (32%) Caucasians were anti-ENA positive compared to 6=12 (50%) Asians and 9=12 (75%) of Afro-Caribbeans (Chi-squared P ‘ 0.01 for Caucasian vs Afro-Caribbean) and these proportions remained essentially unchanged after 10 y of follow-up. However, over the 10 y of follow-up anti-ENA patterns did change, with anti-Ro being the commonest antibody pattern to emerge and anti-Ro/La the commonest antibody pattern to disappear. There were 20=37(54%) Caucasians, 1=12(8%) Afro-Caribbeans and 5=12(42%) Asians who remained negative for anti-ENA throughout the 10-year follow-up (Chi-squared P ‘ 0.03 for Caucasian vs Afro-Caribbean). Conclusion: Anti-ENA were more commonly found in the Afro-Caribbean than the Caucasian population. The commonest patterns of anti-ENA differ between ethnic groups and, over a 10-year period, anti-ENA patterns in individual patients changed in a significant number of individuals. However, Caucasians were more likely to remain anti-ENA negative over 10 y of follow-up than Afro-Caribbeans.
Down-regulation of natural killer cells and of g/d T cells in systemic lupus erythematosus. Does it correlate to autoimmunity and to laboratory indices of disease activity?
Authors: Riccieri V , Spadaro A , Parisi G , Taccari E , Moretti T , Bernardini G , Favaroni M R , Strom R 
Published: November 2003

A depletion of natural killer (NK) cells seems to play a role in the course of systemic lupus erythematosus (SLE) whereas the possible involvement in this disease of T cell receptor (TCR) g/d positive T cells is still debated. The aim of this study was to evaluate the peripheral blood mononuclear cells (PBMCs) that express NK surface markers CD16 and CD56 or g/d TCR antigen in 58 SLE patients, investigating the possible role of these cell subsets involved in non-MHC-restricted cytotoxicity and their relationship with the main clinical and laboratory parameters. SLE patients had, with respect to controls, considerably decreased values of NK cells (P < 0.0004 in percentage and P < 0.00004 as absolute number), of non-MHC-restricted T cytotoxic lymphocytes (P < 0.007 and P < 0.0015, respectively) and of T cells expressing g/d TCR (P < 0.02 and P < 0.004, respectively). The absolute numbers of these cell subsets positively correlated to each other (P < 0.009). g/d T cells inversely correlated with higher ESR values, both percentually (P < 0.006; r ‘ 70.367) and in absolute number (P < 0.009; r ‘ 70.350). Moreover, the percentage values of this cell subset inversely correlated with higher levels of CRP (P < 0.05; r ‘ 70.256) while SLE patients with anti-SSB/La antibodies had lower values of T lymphocytes bearing g/d TCR, both as percentage (P < 0.008) and as absolute number (P < 0.02). Our study indicates that non-MHC-restricted cytotoxicity, shared by NK, NK-like and g/d T cells, may be down-regulated in SLE patients, owing to a significant reduction of these PBMC subsets. These specific cell subset impairments seem to affect only some aspects of the disease, suggesting a weakening of the regulatory properties of these cells in the control of different immunological and inflammatory features of SLE, that could be of importance in its clinical expression.
PRISM (Pictorial Representation of Illness and Self Measure) - a novel visual method to assess the global burden of illness in patients with systemic lupus erythematosus
Authors: Büchi S , Villiger P , Kauer Y , Klaghofer R , Sensky T , Stoll T 
Published: November 2003

Objective: For patients with chronic illnesses the global burden of illness is a crucial health measure hitherto neglected in research studies and clinical practice. We tested the application and validity of PRISM (Pictorial Representation of Illness and Self-Measure), a novel visual method for assessing the burden of illness, in patients with systemic lupus erythematosus (SLE). Method: PRISM was applied in a cross sectional sample of 60 patients with SLE. Correlations were assessed between a quantitative measure derived from PRISM (Self-Illness Separation <Eth> SIS) and sociodemographic factors, measures of disease activity, damage, physical and psychological disability variables, as well as coping resources. Results: The PRISM task was understood by all but one patient, and was in every instance completed in less than 3 minutes. SIS correlated with SF-36 physical health, coping resources as assessed by Sense of Coherence (SOC), and age, but not with disease activity or damage. In multiple regression analyses, independent contributions to SIS were observed for SF-36 physical component scale (contributing 12% of the variance). SOC (10%) and age (14%). Conclusion: PRISM is a new non-verbal measure to assess burden of illness. As in previous studies, PRISM was well accepted and understood by patients with SLE, quick to complete, and yielded meaningful information consistent with that in earlier research work.