Tarnished jewellery and skin - a subtle external marker indicating exposure to hydrogen sulfide.

A 39-year-old woman was found lying in the rear of a car at her home address. A smell of rotten eggs was noted and bottles of brick, tile and paver cleaner and lime sulfur were found in the rear of the vehicle. Suicide notes were found in the house. At autopsy there was no evidence of significant trauma with black tarnishing of a silver-coloured ring and a silver-coloured necklace noted with staining of the underlying skin, in keeping with a chemical reaction between hydrogen sulfide and silver. Internally the most significant finding was unusual greenish discolouration of the gray matter of the external and cut surfaces of the cerebral hemispheres, cerebellum and brain stem. No other organs had this discoloration. Death was attributed to hydrogen sulfide poisoning. Skin discoloration from silver jewellery may represent a subtle external marker for lethal or non-lethal hydrogen sulfide exposure.

A single plain ring is not associated with increased bacterial load on hands: An experimental study among healthcare worker students undertaking mock surgery.

BACKGROUND: Adequate hand hygiene is considered as one of the most effective strategies in healthcare-related infection prevention. The potential negative effect of rings in hand disinfection and thus, in increased nosocomial infections rates is still controversial. Therefore, the present study was designed with the purpose of examining if rings frequently exposed to surgical scrubbing were associated or not with increased bacterial counts. METHODS: 32 volunteers were randomized into 4 groups: A (no rings), B (participants wore a ring), C (no rings and performed surgical scrubbing with chlorhexidine every 48 h) and D (participants wore a ring and performed surgical scrubbing every 48 h). Glove juice samples were obtained at day 0 (T0) and after a 90-min mock-surgery on day 14 (T1). Quantitative (number of UFC/mL) and qualitative data (microorganism type) were collected as study variables. RESULTS: All groups were comparable at T0. All ring carriers obtained negative cultures at T1. Ring presence was not associated with higher bacterial counts; comparisons between A vs B groups and C vs D groups showed no statistically significant differences (p = 0.076 and 1.000). T1 negative cultures were more frequent in participants performing surgical scrubbing every second day (93.8 % vs 75 %), although this difference did not reach statistical significance (p = 0.332). CONCLUSIONS: The presence of single plain ring does not seem to be associated with an increased hand bacterial load. Regular surgical scrubbing with chlorhexidine impregnated sponges reduces bacterial contamination of hands, even in the presence of plain rings.

The Use of Polymer Membranes for the Recovery of Copper, Zinc and Nickel from Model Solutions and Jewellery Waste.

A polymeric inclusion membrane (PIM) consisting of matrix CTA (cellulose triacetate), ONPPE (o-nitrophenyl pentyl ether) and phosphonium salts (Cyphos 101, Cyphos 104) was used for separation of Cu(II), Zn(II) and Ni(II) ions. Optimum conditions for metal separation were determined, i.e., the optimal concentration of phosphonium salts in the membrane, as well as the optimal concentration of chloride ions in the feeding phase. On the basis of analytical determinations, the values of parameters characterizing transport were calculated. The tested membranes most effectively transported Cu(II) and Zn(II) ions. The highest recovery coefficients (RF) were found for PIMs with Cyphos IL 101. For Cu(II) and Zn(II), they are 92% and 51%, respectively. Ni(II) ions practically remain in the feed phase because they do not form anionic complexes with chloride ions. The obtained results suggest that there is a possibility of using these membranes for separation of Cu(II) over Zn(II) and Ni(II) from acidic chloride solutions. The PIM with Cyphos IL 101 can be used to recover copper and zinc from jewellery waste. The PIMs were characterized by AFM and SEM microscopy. The calculated values of the diffusion coefficient indicate that the boundary stage of the process is the diffusion of the complex salt of the metal ion with the carrier through the membrane.

An analysis of the utilisation of medical identification jewellery among children and young adults with type 1 diabetes mellitus in Australia.

AIMS: People with type 1 diabetes mellitus (T1DM) are at risk of life-threatening illness. Medical jewellery is recommended for emergencies, but its uptake is unknown. This study assessed the use of medical jewellery among people with T1DM aged 0-24 years in Australia. METHODS: A cross sectional analysis of subscription data to the largest medical identification jewellery service in Australia was analysed by age, sex and geographic location using Australian population data from 2018. RESULTS: There were 1599 people with T1DM aged 0-24 in the database, but only 1061 had an active subscription, corresponding to an active subscription rate of 13.28/100,000 population or ~5% of the estimated patient population. Half of the active subscribers were male (543/1061, 51/3%). The average age of active subscribers was 17; very few (n = 12, 1.1%) were aged less than 5; and the highest number (n = 141, 39%) was in the 20-24 age group. Active subscription rates varied significantly by geographic location. 88.4% of active subscribers had a diagnosis of T1DM or equivalent inscribed on their emblem, while engraved instructions for management in an emergency were only included in 1.8% of records (n = 19). CONCLUSIONS: Medical jewellery subscription rates were lower than expected; increased with age; and varied significantly by state/territory. The use of medical identification jewellery may be limited by the lack of suitable engraved instructions for use in an emergency. Factors leading to low use should be addressed. Photo 1 Medical Jewellery with emblem.

Use of medical identification jewellery in children and young adults with adrenal insufficiency in Australia.

PURPOSE: Patients with adrenal insufficiency (AI) are at risk of life-threatening illness. Medical jewellery is recommended for emergencies, but its uptake is unknown. This study assessed the use of medical jewellery among Australian AI patients aged 25 years and under. METHODS: Data on the age, sex, region, and diagnosis of subscribers to the largest medical jewellery provider in Australia were analysed. Subscription rates were calculated using 2017 Australian population data. RESULTS: There were 666 patients aged 25 years and under in the database but only 358 (53.8%) had an active (up to date) subscription, corresponding to a subscription rate of 43.67/million or approximately 14.6% of the estimated patient population. The majority (n = 238, 66.5%) had primary AI; followed by secondary AI (n = 82, 22.9%); and the remaining patients (n = 38, 10.6%) could not be classified. Congenital adrenal hyperplasia (CAH) was the most frequent diagnosis (n = 153, 42.7%), corresponding to a subscription rate of 18.67/ million or 28.9% of the estimated number of patients with CAH. The mean age of subscribers was 15.9 (SD = 5.8) years. Only 18 (5%) patients were aged under 5 years. More females (n = 199, 55.9%) than males were active subscribers and subscription rates differed significantly by geographic area. Inactive (lapsed) subscriptions increased with age and were highest in the 20-25 year age group. CONCLUSION: Subscription rates were lower than recommended; increased with age; and were more common in females. Older age was associated with higher levels of lapsed subscriptions. Factors leading to low use and discontinuation in young adults should be addressed.

Nickel release from metallic earrings: A survey of the Danish market and validation of the nickel spot test.

BACKGROUND: Exposure to nickel-releasing ear-piercing jewellery may explain the persistently high prevalence of nickel allergy in Europe. While nickel release from earrings is regulated, field studies show that the regulation is not always respected. More knowledge is needed regarding the risk of piercing exposure including suitable screening methods. OBJECTIVE: To examine the proportion of earrings on the Danish market that release more nickel than allowed, and to validate the use of the dimethylglyoxime (DMG) test as a screening tool. METHODS: A total of 304 earrings were purchased and tested with the DMG test and X-ray fluorescence spectrometry. The level of nickel release was quantified in a selected subsample of 100 earrings by the European reference test EN 1811. The DMG spot test was validated against EN 1811 at different thresholds. RESULTS: Excessive nickel release according to the European regulation was found in 45 (14.8%) tested earrings. The sensitivity of the DMG test decreased with reduced levels of nickel release (sensitivity of 45.2% at ≥0.2 µg/cm2 /week vs 61.1% at >0.5 µg/cm2 /week). CONCLUSION: Excessive nickel release is common in earrings on the Danish market. Because of low sensitivity, the DMG test has limited use in screening of earrings for research but may still be used clinically.

Environmentally friendly process instead of cyanide leaching on recycling of gold and silver from jewellery scraps and wastes.

Nowadays, the production and exploration of gold has an increased importance all over the world. Recycling is a significant source for the supply of gold and has a pronounced effect on its price. The flotation method, which is more economical and more environmentally friendly than cyanide leaching, has been investigated for recycling gold and silver from jewellery slag. A jewellery slag sample containing 28.3 ppm Au and 42.0 ppm Ag was obtained from a refinery in Turkey. Flotation concentrate assaying 614.6 ppm Au and 511 ppm Ag was achieved with recoveries of 89.0% and 83.2%, respectively. On the other hand, 87.8% Au and 81.5% Ag extractions were obtained by cyanide leaching tests. Based on these results, flotation is suggested, considering its environmental and economic benefits.

DNA damage analysis concerning GSTM1 and GSTT1 gene polymorphism in gold jewellery workers from Peshawar Pakistan.

PURPOSE: To evaluate the genotoxic effects of gold jewellery fumes and its association with GSTM1 and GSTT1 genetic polymorphisms. MATERIALS AND METHODS: We examined 94 subjects including 54 gold jewellery workers and 40 controls. The DNA damage was evaluated by alkaline comet assay and genotyping by PCR. RESULTS: The mean total comet score (TCS) in gold jewellery workers was significantly higher as compared to the control subjects (128.0 ± 60.6 versus 47.7 ± 21.4; p = 0.0001). Duration of occupational exposure had positive correlation (r = 0.453, p < 0.01) with DNA damage. Age and tobacco use had significant effects on the TCS of the exposed group as compared to the control group (p < 0.05). The frequency of the GSTM1-null genotype in the exposed group was significant (p = 0.004) as compared to the control group. No significant association (p > 0.05) between the GSTM1 and GSTT1 genotypes and DNA damage was found. CONCLUSIONS: Our results suggest that there is increased DNA damage in gold jewellery workers due to their occupational surroundings. Hence there is a strong need to educate the workers about the adverse health effects of potentially hazardous chemicals and highlight the importance of using protective measures.

Fashion for a reason: Oral jewellery to aid forensic odontology.

Jewellery along with other personal effects have been used for human identification and acknowledged in the INTERPOL (The International Criminal Police Organization) DVI (disaster victim identification) forms. It is hypothesised that modified oral jewellery has scope as a unique personal effect that can be used in combination with other identifiers. The main aim of this study was to investigate the opinions on the use of modified tooth/oral jewellery items among 90 subjects. The secondary aim was to create and suggest an elaborated oral charting system to document oral jewellery and tooth modifications and respective abbreviations. A number of 30 dental students, 30 dentists and 30 designers/tattoo & piercing artists (groups G1, G2 and G3) responded to online closed-ended surveys (versions V1, V2 and V3). As results, G1 considered jewellery 'fashion/contemporary' (77%), unique and accepted the idea of wearing a customised oral jewellery (equally 47%). G2 considered oral jewellery as 'disgusting/vile fashion' (46.66%), unique (60%) and person' (60%). 53% accepted the idea of presenting oral jewellery to their patients. G3 associated it to 'a sign of rebellion' (53.3%), unique (40%) and accepted the idea of making customised oral jewellery (50%)Preferable designs were tooth jewel (G1), implant with Hallmark (G2) and fixed tooth ring (G3). As conclusions, oral jewellery and piercings are highly acceptable by the dental students but the uniqueness of oral jewellery was more recognized by the dentists. Modified oral jewellery has been fairly accepted among all but the preferable type of design varied. A recording of those by the dentist could potentially aid in forensic dental identifications. Therefore, an elaborated oral charting system to document oral jewellery and tooth modifications and respective abbreviations were also suggested to grant a useful reason to this fashion.

The use of medical identification jewellery in adults with adrenal insufficiency in Australia.

OBJECTIVE: Hydrocortisone stress dosing during illness can prevent adrenal crises (AC) in patients with adrenal insufficiency (AI). When patients cannot communicate, medical identification jewellery may facilitate parenteral hydrocortisone provision but patient adoption rates are not known. DESIGN: A cross-sectional analysis of Australian medical identification jewellery subscription data. PATIENTS: Patients with AI aged 20 years and over with an active subscription to a large medical jewellery provider. MEASUREMENTS: Subscription rates by AI subtype, geographic area, age and gender. RESULTS: There were 1955 patients with AI and an active subscription in the database, corresponding to a subscription rate of 105.79/million or approximately one-third of the AI population. The subscription rate was substantially higher in primary AI (60.72/million) than secondary AI (23.16/million), corresponding to approximately 60.7% and 11.6% of the estimated population prevalence of each disorder, respectively. There was substantial variation in use by state/territory, with the highest subscribing state having a rate of over four times that of the lowest (P < 0.001). Women comprised 64.8% (n = 1266) of the group. Subscription also varied by age, being highest in the 60-69 year age group (165.15/million) and lowest in those aged 30-39 years (47.23/million) (P < 0.001). Few patients (4.8%, n = 94) mentioned, either in their record or on their jewellery, the need for urgent parenteral hydrocortisone in the event of severe illness. CONCLUSIONS: Medical jewellery is a component of AC risk reduction. However, subscription appears to be underutilised in the Australian AI population, especially among patients with secondary AI. Urgent treatment recommendations should be inscribed on the jewellery.

Assessing population changes of historically overexploited black corals (Order: Antipatharia) in Cozumel, Mexico.

Black corals (Antipatharians) are crucial structural and ecological components of many mesophotic coral ecosystems (MCEs; reefs 30-150 m depth). In Mexico, black corals are harvested for the jewellery industry, which has historically led to population depletion. Harvesting began in the early 1960s and was concentrated around Cozumel Island until 1995. Since then, harvesting permits have been granted only for the mainland coast. Here we compare Cozumel populations between 1998 and 2016 for the two black coral species targeted by the jewellery industry. We found that densities of Plumapathes pennacea in 2016 were substantially lower than in 1998. However, the 2016 P. pennacea population has shifted to be dominated by larger colonies, suggesting disproportionate juvenile mortality or recruitment failure. Low numbers of Antipathes caribbeana were recorded, and no change in population density or colony size was detected between 1998 and 2016. Despite harvesting occurring for almost 70 years in the Mexican Caribbean, no information on reproduction, recruitment and other dynamics of the targeted species is available. We advocate for harvesting permits to be based on scientific evidence, and for implementation of future restrictions to prevent total depletion of black corals in the area.

In vitro permeation of palladium powders through intact and damaged human skin.

The use of palladium (Pd) has grown in the last decades, commonly used in automotive catalytic converters, jewellery and dental restorations sectors. Both general and working population can be exposed to this metal, which may act as skin sensitizer. This study investigated in vitro palladium powders permeation through excised intact and damaged human skin using the Franz diffusion cell method and the effect of rapid skin decontamination using sodium laureth-sulphate. 1 mL of a 10 min sonicated suspension made of 2.5 g of Pd powder in 50 mL synthetic sweat at pH 4.5 and room temperature was applied to the outer surface of the skin membranes for 24 h. Pd permeation, assessed by ICP-MS, was higher when damaged skin was used (p = 0.03). Final flux permeation values and lag times were 0.02 ±â€¯0.01 µg cm-2 h-1 and 6.00 ±â€¯3.95 h for intact, and 0.10 ±â€¯0.02 µg cm-2 h-1 and 2.05 ±â€¯1.49 h for damaged skin samples, respectively. Damaged skin protocol enhances Pd skin penetration inside dermal layer (p = 0.04), thus making the metal available for systemic uptake. Pd penetration (p = 0.02) and permeation (p = 0.012) through intact skin decreased significantly when a cleaning procedure was applied. This study demonstrates that after skin exposure to Pd powders a small permeation of the metal happen both through intact and damaged skin and that an early decontamination with a common cleanser can significantly decrease the final amount of metal available forsystemic uptake.

Nickel and cobalt release from earrings and piercing jewellery - analytical results of a German survey in 2014.

BACKGROUND: Nickel and cobalt are important metal allergens, and more knowledge on the levels of exposure to these from everyday contacts is needed. OBJECTIVES: To report the results of a repeat routine surveillance scheme in the Federal Republic of Germany on the release of nickel and cobalt. METHODS: Fifteen laboratories assessed earrings and piercing jewellery items from 12 of the states in 2014, complying with EN 1811:2011 + AC:2012 and using atomic absorption spectrometry, inductively coupled plasma mass spectrometry and inductively coupled plasma optical emission spectrometry for quantification. Kaplan-Meier analysis for left-censored data was employed to account for measurements below the limit of quantification. RESULTS: Nickel release exceeded 0.35 µg/cm2 per week in 26 of 160 piercing posts (16.2%), and 0.88 µg/cm2 per week in 2.0-5.9% of other parts, that is, the current respective 'pass' thresholds, with no change from the previous 2008 survey. The level of cobalt release was lower than that of nickel release, and also significantly lower than in the previous survey. CONCLUSIONS: The finding of the highest level of nickel release from piercing posts, with their deliberately lower threshold of acceptability, is worrying, as is the largely unchanged overall level of nickel release. A regulation on cobalt release is currently lacking; risk assessment and management based on dose-elicitation data are needed.

Assessing the validity of self-reported history of rash caused by metal or jewellery.

BACKGROUND: The use of metal-containing bio-devices is becoming increasingly common. Self-reported history of dermatitis with metal exposure is not established as being predictive for metal allergy. OBJECTIVES: To assess the validity of two screening questions addressing metal allergy. METHODS: At Massachusetts General Hospital Contact Dermatitis Clinic, 2132 consecutive patients were asked either 'Do you get rashes when jewellery touches your skin' (Q1; N = 1816) or 'Do you get rashes when metal touches your skin?' (Q2; N = 316) before being patch tested. RESULTS: Testing showed that 20% of subjects had positive reactions to nickel, 7.4% had positive reactions to cobalt, and 5.8% had positive reactions to chromium. Q1 was 40% sensitive (95%CI: 35-45%). The positive predictive value (PPV) was 51%, and the negative predictive value (NPV) was 82%. Q2 was 77% sensitive (95%CI: 68-84%). The PPV was 71%, and the NPV was 84%. Q2 was 37% more sensitive than Q1 (p < 0.0001), with a higher relative risk (RR) (4.75, p < 0.001) than Q1 (RR = 3.01, p < 0.001). CONCLUSIONS: Patient-reported metal allergy, although not perfect, is a reasonable method for metal allergy screening to help identify those needing further objective evaluation by patch testing.

Medical identification or alert jewellery: an opportunity to save lives or an unreliable hindrance?

Medical identification jewellery can convey vital information to emergency responders, but mistakes and ambiguity may lead to misdiagnosis and morbidity. We performed a review of relevant articles retrieved from Pubmed® , Embase® and Scopus® and Google UK Inc. to investigate the commercial availability and issuance of these products. From 84 identified studies, we shortlisted 74 for review. The Google search retrieved 1,090,000 results within 0.57 s (January 2017). We explored 32 websites selling medical alert jewellery in the first five pages of these results. We found that patients themselves are currently responsible for the engraved wording on medical alert jewellery, with no mandatory physician checks. The accuracy and appropriateness of this information may thus vary. In the absence of national guidance in the UK, we suggest that there should be a list of specific indications warranting their use, a requirement for regular review of information, and clarity around the level of physician input into the engraving chosen. We discuss the potential benefits vs. risks of wearing medical alert jewellery and clarify the limitations of medical teams' responsibilities in relation to patients found to be wearing them.

[Hygiene and care, when the wedding ring becomes nosocomial!] / Hygiène et soins, quand l'alliance devient nosocomiale !

In the care setting, hand washing constitutes an essential measure for preventing hand-transmitted infections. Best practices also recommend the principle of zero jewellery. Not so easy to implement, especially when it comes to the removal of wedding rings. A nurse shares her thoughts on this sensitive issue regarding the safety of care.

A systematic review of animal predation creating pierced shells: implications for the archaeological record of the Old World.

BACKGROUND: The shells of molluscs survive well in many sedimentary contexts and yield information about the diet of prehistoric humans. They also yield evidence of symbolic behaviours through their use as beads for body adornments. Researchers often analyse the location of perforations in shells to make judgements about their use as symbolic objects (e.g., beads), the assumption being that holes attributable to deliberate human behaviour are more likely to exhibit low variability in their anatomical locations, while holes attributable to natural processes yield more random perforations. However, there are non-anthropogenic factors that can cause perforations in shells and these may not be random. The aim of the study is compare the variation in holes in shells from archaeological sites from the Old World with the variation of holes in shells pierced by mollusc predators. METHODS: Three hundred and sixteen scientific papers were retrieved from online databases by using keywords, (e.g., 'shell beads'; 'pierced shells'; 'drilling predators'); 79 of these publications enabled us to conduct a systematic review to qualitatively assess the location of the holes in the shells described in the published articles. In turn, 54 publications were used to assess the location of the holes in the shells made by non-human predators. RESULTS: Almost all archaeological sites described shells with holes in a variety of anatomical locations. High variation of hole-placement was found within the same species from the same site, as well as among sites. These results contrast with research on predatory molluscs, which tend to be more specific in where they attacked their prey. Gastropod and bivalve predators choose similar hole locations to humans. DISCUSSION: Based on figures in the analysed articles, variation in hole-location on pierced shells from archaeological sites was similar to variation in the placement of holes created by non-human animals. Importantly, we found that some predators choose similar hole locations to humans. We discuss these findings and identify factors researchers might want to consider when interpreting shells recovered from archaeological contexts.

Making sense with sensors: Self-tracking and the temporalities of wellbeing.

Self-tracking devices and apps often measure and provide interpretations of personal data in a rather straightforward way, for instance by visualising the speed and distance of a run or the quality of sleep during night. There is, however, a growing number of devices claiming to support increased wellbeing by extensive data analysis to provide insights and algorithmic advice about unseen and neglected dimensions of our lives, bodies, and experiences. This article engages with two devices of this kind, namely the Moodmetric and the OURA which are two recently released 'smart' rings with associated smartphone apps that claim to measure emotions and rest, promote happiness and help users to perform better. Focusing on how certain values, visions and ideas are used to frame and explain the potential functionality of these devices, this article approaches the discursive underpinnings of their design as deeply intertwined with the temporalities of late modernity. Empirically, the article is based on a discourse analysis of blog posts, marketing materials and user guides from the OURA and Moodmetric companies along with video recordings of the public appearances and sales pitches of company representatives.

Spectrophotometric determination of gold(III) in forensic and pharmaceutical samples and results complemented with ICP AES and EDXRF analysis.

Spectrophotometric method with three systems were developed here for the determination of gold(III) using o-dianisidine, aniline sulphate and catechol. Gold(III),in the system 1 it oxidizes o-dianisidine, in the system 2 it oxidizes catechol followed by its coupling with o-dianisidine, in the system 3 it oxidizes catechol followed by its coupling with aniline sulphate forming dye products with respective λmax 446nm, 540nm, and 505nm. All the three systems were optimized and analytical parameters were calculated. The molar absorptivity values were 9.27×104, 1.97×104 and 1.62×104 respectively for the systems 1, 2 and 3 with the corresponding Sandell sensitivity values (µgcm-2), 0.0021, 0.0096 and 0.011. The optimized systems were used for the determination of gold present in some forensic jewellery and pharmaceutical samples and the results obtained were compared with the results of all samples determined by Inductively Coupled Plasma - Atomic Emission Spectrometric method and a few of them were also complemented by Energy Dispersive X-Ray Fluorescent spectral analysis.

Jewellery: alloy composition and release of nickel, cobalt and lead assessed with the EU synthetic sweat method.

BACKGROUND: Several studies have shown nickel and cobalt release from jewellery by using spot tests, but the metal composition of jewellery is largely unknown. OBJECTIVES: To evaluate the metal composition of a large worldwide sample of mainly inexpensive jewellery items, and investigate the release of nickel, cobalt and lead from a subsample by using EN 1811:1998-required methods. METHODS: A total of 956 metallic jewellery components were examined with X-ray fluorescence spectroscopy. A subsample of 96 jewellery items purchased in the United States were investigated for nickel, cobalt and lead release by the use of artificial sweat immersion and plasma optical emission spectroscopy. RESULTS: Eighteen elements were detected. The 10 most frequently occurring were, in order of frequency, copper, iron, zinc, nickel, silver, chromium, tin, manganese, lead, and cobalt. Release of nickel was noted from 79 of the 96 US samples (0.01-98 µg/cm(2) /week), release of cobalt from 35 samples (0.02-0.5 µg/cm(2) /week), and release of lead from 37 samples (0.03-2718 µg/cm(2) /week). CONCLUSIONS: We present here a comprehensive list of the most frequently encountered metals in jewellery and fashion accessories. Different allergenic and non-allergenic metals are utilized. We also report the frequent release of nickel, cobalt and lead from these objects, despite legislative restrictions.