"Why some consumers don't care": Heterogeneity in household responses to a food scandal.

In the aftermath of food scandals, household perceptions about the health risks posed by failures in food safety play a central role in determining their mitigating behavior. A stream of literature has shown that factors including media coverage of a scandal, risk perceptions, trust in food safety information, and consumption habits matter. This paper deviates from the standard assumption of a homogeneous response to media information across all households exposed to a food scandal. Instead, we present an innovative multi-method approach to investigate the impacts of household heterogeneity in underlying psychological and behavioral, media usage patterns and consumption habits on poultry demand in the aftermath of the 2011 German dioxin scandal. The analysis employs weekly retail purchase and matching survey data for 6133 households covering pre and post scandal periods. The supplementary survey data elicits household respondent's risk perceptions and risk attitudes, product label and media information behavior. Initial factor and cluster analysis identify household segments based on psychographic and behavioral indicators. We then estimate a correlated random effect Tobit model to account for clustered household responses to quantify the influence of media effects distinguishing between short-term risk mitigation behavior and longer-term habit persistence. Our results confirm significant heterogeneity in household's media-induced risk-mitigation responses to the dioxin scandal across three clusters. However, we find that habit persistence in the form of consumption preferences for the affected products were able to largely compensate for demand-reducing media effects across household clusters. Considering heterogeneity in household's risk mitigation behaviors to food scandals holds implications for policy makers and food industry alike.

Comparison of safety, efficacy and tolerability of dexibuprofen and ibuprofen in the treatment of osteoarthritis of the hip or knee.

In this observer-blinded, multicenter, non-inferiority study, 489 patients suffering from painful osteoarthritis of the hip or knee were included to investigate safety and tolerability of Dexibuprofen vs. Ibuprofen powder for oral suspension. Only patients who had everyday joint pain for the past 3 months and "moderate" to "severe" global pain intensity in the involved hip/knee of within the last 48 h were enrolled. The treatment period was up to 14 days with a control visit after 3 days. The test product was Dexibuprofen 400 mg powder for oral suspension (daily dose 800 mg) compared to Ibuprofen 400 mg powder for oral suspension (daily dose 1,600 mg). Gastrointestinal adverse drug reactions were reported in 8 patients (3.3 %) in the Dexibuprofen group and in 19 patients (7.8 %) in the Ibuprofen group. Statistically significant non-inferiority was shown for Dexibuprofen. Comparing both groups by a Chi square test showed a statistical significant lower proportion of related gastrointestinal events in the Dexibuprofen group. All analyses of secondary tolerability parameters showed the same result of a significantly better safety profile in this therapy setting for Dexibuprofen compared to Ibuprofen. The sum of pain intensity, pain relief and global assessments showed no significant difference between treatment groups. In summary, analyses revealed at least non-inferiority in terms of efficacy and a statistically significant better safety profile for the Dexibuprofen treatment.

Tooth autotransplantation in a free iliac crest graft for prosthetic reconstruction.

This report documents successful tooth autotransplantation to a free iliac crest graft in an exemplar case. A 14-year-old male patient was operated thrice with increasing amounts of resection for recurrent odontogenic myxoma. When mandibular continuity resection finally was performed, a free iliac crest block autotransplant was used for reconstruction. Upon metal removal 5 months later, 3 wisdom teeth with two-thirds complete root development were transplanted to the free graft and retained by fixed orthodontic appliances including skeletal anchorage with orthodontic microscrews. Tooth graft taking was awaited for 8 weeks with retention. Following undisturbed healing without occlusal forces, 6 months of orthodontic treatment intentionally extruded the autotransplanted teeth to antagonist contact. The third and most dorsal tooth became mobile after 3 months and was lost. The surviving 2 teeth were fitted by a prosthetic bridge as extrusion into the occlusal plane was not completely successful. This exemplar case shows benefit of tooth autotransplants in selected cases of jaw reconstruction with distal bone autotransplants as alternative to dental titanium implants and suprastructures. Orthodontic microscrews can moreover support tooth movement and positioning as anchorage device in altered anatomy.

Critical evaluation of piezoelectric osteotomy in orthognathic surgery: operative technique, blood loss, time requirement, nerve and vessel integrity.

PURPOSE: Piezo-osteotomy feasibility as a substitute for the conventional saw in orthognathic surgery was evaluated regarding operative technique, blood loss, time requirement, and nerve and vessel integrity. PATIENTS AND METHODS: Fifty patients had orthognathic surgery procedures in typical distribution using piezosurgical osteotomy: 22 (44%) monosegment, 26 (52%) segmented Le Fort I osteotomies; 48 (48%) sagittal split osteotomies, 6 (12%) symphyseal, and 4 (4%) mandibular body osteotomies. Controls were 86 patients with conventional saw and chisel osteotomies: 57 (66%) monosegment, 25 (29%) segmented Le Fort I osteotomies, 126 (73%) sagittal split, and 4 (5%) symphyseal osteotomies. RESULTS: Piezosurgical bone osteotomy permitted individualized cut designs, enabling segment interdigitation after repositioning. Angulated tools weakened the pterygomaxillary suture; auxiliary chisels were required in 100% of cases for the nasal septum, and lateral nasal walls as 46% pterygoid processes. After downfracture, the dorsal maxillary sinus wall and pterygoid processes were easily reduced. Hemorrhage was successfully avoided with average blood loss of 541 +/- 150 mL versus 773 +/- 344 mL (P = .001) for a conventional bimaxillary procedure. Sagittal mandibular osteotomy required considerable time (auxiliary saw in 13%); the lingual dorsal osteotomy was mostly performed tactile. Time investment remained unchanged: 227 +/- 73 minutes per bimaxillary standard osteotomy versus 238 +/- 61 minutes (P = .5); clinical courses and reossification were unobtrusive. Alveolar inferior nerve sensitivity was retained in 95% of the study collective versus 85% in the controls (P = .0003) at 3 months postoperative testing. CONCLUSIONS: Piezoelectric osteotomy reduced blood loss and inferior alveolar nerve injury at no extra time investment. Single cases require auxiliary chiseling or sawing. Piezoelectric drilling for screw insertion and complex osteotomy designs may be developed to maintain bone contact or interdigitation after repositioning and minimize need for osteofixation.

Cervical lymph nodes.

The lymph node staging is a very important prognostic parameter for patients with presenting with head neck cancer and is influencing the selection of the different therapeutic strategies including surgery, chemotherapy, radiotherapy or a combination of them. The accuracy of imaging techniques, such as US, MR imaging, and CT, depends on the appropriateness of radiological criteria used for diagnosing lymph node metastases. Size of nodes and evidence of necrosis are still the most important radiological criteria. However, the size shows great variability. A spherical lymph node larger than 10mm is an indicator for a malignant node, whereas an oval shape and/or a fatty hilus are more benign signs. But there are many limitations and different cut offs published in the literature, indicating that the size of a lymph node is not a reliable criteria for the assessment of lymph nodes in the head and neck region. Today new high-resolution MRI sequences and the development of specific contrast agents are offering new possibilities in the diagnostic work-up of head and neck lymph nodes. Ultrasmall superparamagnetic iron oxide particles (USPIO's) are resulting after intravenous application in a reduction of the T2 relaxation time. This is causing a signal decrease on T2-weighted MR images in benign lymph nodes after administration of USPIO's, whereas malignant lymph nodes do not show a significant signal decrease. Some clinical studies presented already very promising results. Based on the fact, that the size evaluation of lymph nodes in the head and neck has not changed during the last decade, this paper will mainly focus on MRI with new contrast agents and new techniques as diffusion weighted imaging (DWI).

Bone harvesting at the anterior iliac crest using piezoosteotomy versus conventional open harvesting: a pilot study.

OBJECTIVE: The objective of this study was to evaluate piezoosteotomy for bone harvesting at the iliac crest in a pilot collective. STUDY DESIGN: Thirteen patients underwent anterior iliac crest bone graft harvesting using piezoosteotomy. These patients were compared to an age- and sex-matched retrospective cohort of 13 patients who underwent bone graft harvesting at the anterior iliac crest using conventional chisels and saws in an otherwise identical protocol. RESULTS: Harvested bone volumes and operation times were comparable; hospitalization time was briefer and pain levels at the first 2 postoperative days less in the piezoosteotomy group; pain medication requirement was comparable. Spearman's-rho correlation showed a strong tie between pain medication requirement and harvested bone volume in the piezoosteotomy group and between harvested bone volume and operation time in the conventional surgery collective. CONCLUSIONS: The correlation between required pain medication and harvested bone volume together with lower pain levels in the piezoosteotomy group indicate pain more exclusively related to local osseous damage than to correlated soft tissue lacerations. Conventional technique shows a correlation between operation time and harvested bone volume indicating a more time-effective procedure, although total operation time was comparable. Piezoosteotomy appears to have potential use in iliac crest bone harvesting.

Iron oxide particle-enhanced magnetic resonance imaging for detection of benign lymph nodes in the head and neck: how reliable are the results?

AIM: To evaluate the accuracy of ultrasmall paramagnetic iron oxide (USPIO: Sinerem)-enhanced MRI in patients with head and neck cancer and enlarged lymph nodes compared with current staging examinations using histology as a gold standard. PATIENTS AND METHODS: Seventeen patients with a histologically proven squamous cell cancer of the head and neck (SCCHN) and different N-stages underwent a non-enhanced and a USPIO-enhanced MRI examination. Signal intensity (SI) was measured in a region of interest evaluation. Pathohistological examination was used as a reference. RESULTS: On a patient basis, USPIO-enhanced MRI showed a higher specificity and diagnostic accuracy (94%) compared with non-enhanced MRI (53%). One patient showed a lymph node of 6 mm in the short axial diameter which was suggested as being metastatic in Sinerem-enhanced MRI according to the enhancement pattern of Sinerem. This patient was staged as N1 with Sinerem-enhanced MRI. The histopathological examination did not confirm the Sinerem-enhanced MRI result. CONCLUSION: The high values for the specifity and diagnostic accuracy of Sinerem- enhanced MRI justifies further investigations with this contrast agent. USPIO-enhanced MRI could be advantageous in avoiding surgical overtreatment.