Ethnocentrism in Austria - Historical data.

This data article offers three inter-connected, historical datasets regarding consumer ethnocentrism in Austria. (1) The first dataset (cet-dev) was used for scale development. It replicates and extends the US-CETSCALE, developed by Shimp and Sharma [1]. It was drawn on a quota-sampling technique (n = 1105), representative of the Austrian population in 1993 and examines perceptions regarding foreign-made products. (2) The second dataset (cet-val) was used for scale validation, again drawn from a representative sample of the Austrian population in 1993-1994 (n = 1069), and (3) the third dataset (cet-xtrmgrp) drew on a snowball sample of members of the Austrian army (n = 105) and members of export-oriented firms (n = 72), thus providing an 'extreme group' validation opportunity for the Austrian CETSCALE. The data can be reused for factor analytic multivariate procedures, to test antecedents and consequences of consumer ethnocentrism in the Austrian context and provide historic value, if pooled and reused with contemporary data.

A perspective on using partial least squares structural equation modelling in data articles.

This perspective article on using partial least squares structural equation modelling (PLS-SEM) is intended as a guide for authors who wish to publish datasets that can be analysed with this method as stand-alone data articles. Stand-alone data articles are different from supporting data articles in that they are not linked to a full research article published in another journal. Nevertheless, authors of stand-alone data articles will be required to clearly demonstrate and justify the usefulness of their dataset. This perspective article offers actionable recommendations regarding the conceptualisation phase, the types of data suitable for PLS-SEM and quality criteria to report, which are generally applicable to studies using PLS-SEM. We also present adjusted versions of the HTMT metric for discriminant validity testing that broaden its applicability. Further, we highlight the benefit of linking data articles to already published research papers that employ the PLS-SEM method.

E-commerce Policy and the Global Economy: A Path to More Inclusive Development?

The advancement of digitalization is gradually transforming the existing structure of the global economy. According to the McKinsey Global Institute, almost all cross-border transactions had a digital component in 2016. This is also reflected by the growing literature on digitalization and E-commerce. Yet, studies specifically focusing on E-commerce policy are scarce compared with other areas in this domain. By going beyond academic articles and including policy documents in our analysis, this study takes stock of the issues as well as the policy recommendations identified in these publications. Our analysis reveals that to promote an inclusive E-commerce participation, it is imperative to design policies that improve countries' formal institutions, facilitate the inclusion of less-developed countries in the E-commerce space, and enhance E-commerce adoption by small- and medium-sized enterprises. We highlight the significance of collaboration between and solidarity among governments and other stakeholders.

Fractures of the mandibular condyle: A comparison of patients, fractures and treatment characteristics between Groningen (The Netherlands) and Dresden (Germany).

PURPOSE: To explore differences in patient, fracture, accident and treatment characteristics between patients treated for a mandibular condyle fracture in the University Centres of Dresden and Groningen, as an explanation for differences treatment results. MATERIALS AND METHODS: Patients' fracture, accident and treatment characteristics were obtained from the medical records of Dresden and Groningen from January 1, 2008, to August 31, 2011, and were analysed using logistic regression analysis. RESULTS: In Dresden, compared to Groningen, patients were generally older (OR 1.03, 95% CI 1.02; 1.05, per year), were more often male (OR 2.54, 95% CI 1.48; 4.34) and more often had intracapsular (OR 2.95, 95% CI 1.67; 5.22) and low condylar (OR 1.86, 95% CI 1.14; 3.04) fractures. In Groningen 98% of patients received closed treatment and in Dresden 42%. CONCLUSION: Significant differences in patients and fractures and treatments were found between both Centres. These differences can partly be explained by the demographics of the cities and differences in imaging techniques (e.g., computed tomography, Orthopantomogram, Towne projection) applied to identify fractures. This study illustrates that differences in diagnosis, treatment and outcome are not only related to the health care system but also to differences in patient characteristics between centres.

Teledermatology leading to an important diagnosis in an underserved clinic.

Cutaneous signs can be the first manifestation of important medical diagnoses, including inherited cancer syndromes, but access to dermatologic evaluation is especially challenging for uninsured patients. Herein, we present a case in which a volunteer academic teledermatology triage program was used by a community health clinic to make a diagnosis of multiple cutaneous leiomyomas, which confer a high likelihood of hereditary leiomyomatosis and renal cell cancer syndrome, also known as Reed syndrome; this prompted malignancy screening for the patient. Importantly, this case underscores the potential for teledermatology to improve access to dermatologist evaluation and make crucial diagnoses in patients with barriers to care.

The Guatemala-Penn Partners: An Innovative Inter-Institutional Model for Scientific Capacity-Building, Healthcare Education, and Public Health.

Population health outcomes are directly related to robust public health programs, access to basic health services, and a well-trained health-care workforce. Effective health services need to systematically identify solutions, scientifically test these solutions, and share generated knowledge. The World Health Organization (WHO)'s Global Healthcare Workforce Alliance states that the capacity to perform research is an essential factor for well-functioning public health systems. Low- and middle-income countries have greater health-care worker shortages and lower research capacity than higher-income countries. International global health partnerships between higher-income countries and low-middle-income countries aim to directly address such inequalities through capacity building, a process by which human and institutional resources are strengthened and developed, allowing them to perform high-level functions, solve complex problems, and achieve important objectives. The Guatemala-Penn Partners (GPP) is a collaboration among academic centers in Guatemala and the University of Pennsylvania (Penn), in Philadelphia, Pennsylvania that echoes the vision of the WHO's Global Healthcare Workforce Alliance. This article describes the historical development and present organization of the GPP according to its three guiding principles: university-to-university connections, dual autonomies with locally led capacity building, and mutually beneficial exchanges. It describes the GPP activities within the domains of science, health-care education, and public health, emphasizing implementation factors, such as sustainability and scalability, in relation to the guiding principles. Successes and limitations of this innovative model are also analyzed in the hope that the lessons learned may be applied to similar partnerships across the globe.

Synovial chondromatosis of the temporomandibular joint: Immunohistochemical examinations regarding the role of insulin-like growth factors and their binding proteins in the etiology of this disease.

Synovial chondromatosis (SC) is a benign disease of the joints without a known cause. It sometimes affects the temporomandibular joint (TMJ) and is accompanied by pain, swelling, malocclusion, and crepitation. It has been divided into three stages by Milgram and is supposed to originate from the synovia and cartilage of a joint (Milgram, 1977b). The aim of this study was to examine an involvement of the insulin-like growth factors (IGF-I/-II) and their binding proteins (IGFBP-1 to -6) in the etiology of this disease. Therefore 23 specimen of SC from 16 patients were immunohistochemically stained and microscopically examined. Staining was assessed semiquantitatively: negative (-), weakly positive ((+)), moderately positive (+), strongly positive (++) and very strongly positive (+++). It could be seen that especially the chondro- and fibrocytes and the synovia showed positive staining for almost all IGFs and IGFBPs. The underlying tissue, consisting of connective tissue or chondroid matrix, was stained as well but more weakly so. We conclude that the IGF/IGFBP system seems to contribute to the pathogenesis of SC, especially IGF-I and -II, and their effects enhancing binding protein 5.

Hemostatic action of polyurethane foam with 55% polyethylene glycol compared to collagen and gelatin.

BACKGROUND: For most topical hemostatic agents the mechanism of hemostatic action is not fully understood. OBJECTIVE: This work aimed to investigate the hemostatic mechanism of action and viscoelastic properties of polyurethane foam (PU) in comparison to the widely used collagen and gelatin. METHODS: The hemostatic mechanism of action of the materials was tested using human whole blood and platelet-poor plasma (PPP). The ability of the hemostatic agent to exert pressure on the wound was quantified in terms of its viscoelastic properties both under dry and wet conditions using a low load compression tester (LLCT). RESULTS: It has been shown that collagen and PU initiate hemostasis through both thrombocyte aggregation and contact activation of the coagulation cascade. Gelatin did not show improved thrombocyte aggregation or initiation of the coagulation cascade compared to the negative control group. PU is more firm under wet conditions and shows more springback than collagen and gelatin. CONCLUSIONS: We conclude that PU is promising as a topical hemostatic agent because it initiates both the coagulation cascade and thrombocyte aggregation. Furthermore, it has favorable viscoelastic properties compared to collagen and gelatin which leads to increased pressure on a wound.

Impact of store-and-forward (SAF) teledermatology on outpatient dermatologic care: A prospective study in an underserved urban primary care setting.

BACKGROUND: The clinical value of teledermatology in the primary care setting remains relatively unknown. OBJECTIVE: We sought to determine the impact of teledermatology on outpatient diagnosis, management, and access to dermatologic care in a resource-poor primary care setting. METHODS: We performed a prospective study of store-and-forward teledermatology consults submitted between January and November 2013 from 11 underserved clinics in Philadelphia to the University of Pennsylvania using mobile devices and the Internet. We assessed diagnostic and management concordance between primary care providers and dermatologists, time to consult completion, anticipated level of dermatology input in the absence of teledermatology, and number of consults managed with teledermatology alone. RESULTS: The study included 196 consults encompassing 206 dermatologic conditions. Diagnoses and management plans of primary care providers and dermatologists were fully concordant for 22% and 23% of conditions, respectively. The median time to consult completion was 14 (interquartile range 3-28) hours. At least 61% of consults would not otherwise have received dermatology input, and 77% of consults were managed with teledermatology alone. LIMITATIONS: Lack of a diagnostic gold standard, limited patient follow-up, and uncertain generalizability are limitations. CONCLUSION: Teledermatology is an innovative and impactful modality for delivering dermatologic care to outpatients in resource-poor primary care settings.

In vivo degradation of polyurethane foam with 55 wt % polyethylene glycol.

Most topical hemostatic agents are based on animal-derived products like collagen and gelatin. They carry the potential risk of pathogen transmission while adjustments in the production process of these materials are limited. A synthetic hemostatic agent based on polyurethane (PU) and polyethylene glycol (PEG) was developed to overcome these disadvantages. The goal of this study was to compare the degradation process of this biomaterial to collagen and gelatin hemostatic agents. Samples of the test materials were implanted subcutaneously in both rats and rabbits. The animals were sacrificed at certain time intervals up to three years and the explanted samples were microscopically assessed. The histological examination showed a comparable pattern of degradation for the different test materials. Remnants of gelatin and collagen were seen up to 26 and 39 weeks, respectively. For PU, it took up to three years before micro-particles of the material were no longer detected. All biomaterials showed a good biocompatibility and no severe foreign body reactions occurred. The good biocompatibility and predictable pattern of resorption indicate that PU can be used as a topical hemostatic agent. However, a degradation time comparable to collagen and gelatin would be favorable.

Long-term health outcomes and cost-effectiveness of a computer-tailored physical activity intervention among people aged over fifty: modelling the results of a randomized controlled trial.

BACKGROUND: Physical inactivity is a significant predictor of several chronic diseases, becoming more prevalent as people age. Since the aging population increases demands on healthcare budgets, effectively stimulating physical activity (PA) against acceptable costs is of major relevance. This study provides insight into long-term health outcomes and cost-effectiveness of a tailored PA intervention among adults aged over fifty. METHODS: Intervention participants (N = 1729) received tailored advice three times within four months, targeting the psychosocial determinants of PA. The intervention was delivered in different conditions (i.e. print-delivered versus Web-based, and with or without additional information on local PA opportunities). In a clustered RCT, the effects of the different intervention conditions were compared to each other and to a control group. Effects on weekly Metabolic Equivalents (MET)-hours of PA obtained one year after the intervention started were extrapolated to long-term outcomes (5-year, 10-year and lifetime horizons) in terms of health effects and quality-adjusted life years (QALYs) and its effect on healthcare costs, using a computer simulation model. Combining the model outcomes with intervention cost estimates, this study provides insight into the long-term cost-effectiveness of the intervention. Incremental cost-effectiveness ratios (ICERs) were calculated. RESULTS: For all extrapolated time horizons, the printed and the Web-based intervention resulted in decreased incidence numbers for diabetes, colon cancer, breast cancer, acute myocardial infarctions, and stroke and increased QALYs as a result of increased PA. Considering a societal Willingness-to-Pay of €20,000/QALY, on a lifetime horizon the printed (ICER = €7,500/QALY) as well as the Web-based interventions (ICER = €10,100/QALY) were cost-effective. On a 5-year time horizon, the Web-based intervention was preferred over the printed intervention. On a 10-year and lifetime horizon, the printed intervention was the preferred intervention condition, since the monetary savings of the Web-based intervention did no longer outweigh its lower effects. Adding environmental information resulted in a lower cost-effectiveness. CONCLUSION: A tailored PA intervention in a printed delivery mode, without environmental information, has the most potential for being cost-effective in adults aged over 50. TRIAL REGISTRATION: The current study was registered at the Dutch Trial Register (NTR2297; April 26th 2010).

Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants.

To avoid increasing the risk of thromboembolic events, it is recommended that treatment with anticoagulants should be continued during dentoalveolar operations. We have evaluated the incidence of bleeding after dentoalveolar operations in a prospective study of 206 patients, 103 who were, and 103 who were not, taking anticoagulants. Seventy-one were taking thrombocyte aggregation inhibitors and 32 vitamin K antagonists. Patients were treated according to guidelines developed at the Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. The operations studied included surgical extraction (when the surgeon had to incise the gingiva before extraction), non-surgical extraction, apicectomy, and placement of implants. Patients were given standard postoperative care and those taking vitamin K antagonists used tranexamic acid mouthwash postoperatively. No patient developed a severe bleed that required intervention. Seven patients (7%) taking anticoagulants developed mild postoperative bleeds. Patients taking vitamin K antagonists reported 3 episodes (9%) compared with 4 (6%) in the group taking thrombocyte aggregation inhibitors. Among patients not taking anticoagulants, two (2%) developed mild bleeding. The differences between the groups were not significant. All bleeding was controlled by the patients themselves with compression with gauze. We conclude that dentoalveolar surgery is safe in patients being treated with anticoagulants provided that the conditions described in the ACTA guidelines are met.

Relationship between activity of silica thin films and density of cells occupation.

The SiO2 thin films (STFs) were deposited on the surfaces of stainless steel tapes and their activity was particularly investigated from the aspect of the number density of hydroxyl groups on their surfaces. The calculation procedure of density of active OH groups includes determination of average length of silica chains that constitute silica sol particles with almost uniform size, on the base of thermogravimetric analysis. The size of SiO2 particles is analyzed by transmission electron microscopy and dynamic light scattering method. Fibroblast (L929) cell densities on the surfaces of these films were investigated using phase contrast microcopy. It was shown that there is a relationship between OH group densities and density of attached cells. Besides, the cytotoxicity effect was studied and compared for various thermally treated STFs.

In vivo hemostatic efficacy of polyurethane foam compared to collagen and gelatin.

OBJECTIVES: Topical hemostatic agents are used in all surgical disciplines. Most of these hemostats are based on animal-derived products like collagen and gelatin. They carry the potential risk of pathogen transmission. A newly developed biodegradable, fully synthetic hemostatic agent based on polyurethane foam (PU) with 55 % polyethylene glycol (PEG) would prevent these potential risks. MATERIALS AND METHODS: The hemostatic efficacy of this new agent was compared to gelatin and collagen in humans who underwent extraction of an upper and lower molar (split-mouth model). After extraction of a molar in the maxilla and mandible, a PU foam and collagen or gelatin were inserted in the extraction socket for 2 min. Hereafter, the agents were removed and stored in ethylenediaminetetraacetic acid to stop coagulation. Then, the concentration of coagulation parameters thrombin-antithrombin III (TAT) complexes, fibrinogen, and thromboxane B2 (TxB2) in blood extracts from the agents was measured. The concentrations were also determined in baseline blood samples which were collected from the extraction socket. RESULTS: The concentrations of TAT and TxB2 were significantly increased, and fibrinogen concentration was significantly reduced compared to baseline wound blood concentrations indicating enhanced hemostasis. No significant differences were seen in the concentrations of these coagulation parameters in the three different hemostatic agents. CONCLUSIONS: These results show that PU combined with 55 % PEG is a promising alternative for the animal-derived hemostatic agents. CLINICAL RELEVANCE: The synthetic hemostatic agent could replace the animal-derived products like collagen and gelatin and therewith prevent the potential risk of pathogen transmission.

Composite materials based on poly(trimethylene carbonate) and ß-tricalcium phosphate for orbital floor and wall reconstruction.

Poly(trimethylene carbonate) and ß-tricalcium phosphate (PTMC/ß-TCP) composite materials were prepared by coprecipitation and compression molding. The effect of different amounts of the ceramic component (15 and 30 vol %) on the properties was investigated. The effect of lamination with minimal amounts of poly(D,L-lactide) (PDLLA) was assessed as well. It was hypothesized that these composites would be suitable for orbital floor reconstruction, as the polymer component resorbs enzymatically without the formation of acidic compounds, while the ceramic component could induce bone formation. To asses their suitability as load bearing devices, the flexural properties of the prepared (laminated) composites were determined in three point bending experiments and compared with those of currently used reconstruction devices. The flexural modulus of PTMC composites increased from 6-17 MPa when introducing 30 vol % ß-TCP. A laminate of this composite with PDLLA (with respective layer thicknesses of 0.8 and 0.2 mm) had a flexural modulus of 64 MPa. When evaluated in a mechanical engineering model of the orbital floor the (laminated) composites materials showed similar behavior compared to the currently used materials. The results suggest that from a mechanical point of view these (laminated) composite sheets should be well suited for use in orbital floor reconstruction.

Response of monocyte-derived dendritic cells to rapidly solidified nickel-titanium ribbons with shape memory properties.

Ni-Ti Shape Memory Alloys (SMAs) have attracted considerable attention as biomaterials for medical devices. However, the biocompatibility of Ni-Ti SMAs is often unsatisfactory due to their poor surface structure. Here we prepared Rapidly Solidified (RS) Ni-Ti SMA ribbons by melt-spinning and their surface was characterised by Auger-electron spectroscopy, X-ray photoelectron spectrometry and scanning electron microscopy. The biocompatibility of the produced ribbons and their immunomodulatory properties were studied on human monocyte-derived dendritic cells (MoDCs). We showed that melt-spinning of Ni-Ti SMAs can form a thin homogenous oxide layer, which improves their corrosion resistance and subsequent toxicity to MoDCs. Ni-Ti RS ribbons stimulated the maturation of MoDCs, as detected by changes in the cells' morphology and increased expression of HLA-DR, CD86, CD40 and CD83 molecules. However, Ni-Ti RS ribbons enhanced the tolerogenic properties of immature MoDCs, which produced higher levels of IL-10 and IL-27, driving the differentiation of IL-10- and TGF-ß-producing CD4+T cells. On the other hand, in the presence of lipopolysaccharide, an important pro-inflammatory biomolecule, Ni-Ti RS ribbons enhanced the allostimulatory and Th1 polarising capacity of MoDCs, whereas the production of Th2 and Th17 cytokines was down-regulated. In conclusion, Ni-Ti RS ribbons possess substantial immunomodulatory properties on MoDCs. These findings might be clinically relevant, because implanted Ni-Ti SMA devices can induce both desired and adverse effects on the immune system, depending on the microenvironmental stimuli.

Cytotoxicity of gold nanoparticles prepared by ultrasonic spray pyrolysis.

The aim of this work was to study the cytotoxicity of different fractions of gold nanoparticles prepared by ultrasonic spray pyrolysis from gold scrap. The target cells were rat thymocytes, as a type of nonproliferating cells, and L929 mouse fibroblasts, as a type of continuous proliferating cells. Fractions 1 and 2, composed of pure gold nanoparticles, as determined by scanning electron microscopy with a combination of energy dispersive X-ray analysis, were nontoxic for thymocytes, but reduced moderately the proliferative activity of L929 cells. The inhibitory effect of fraction 2, containing particles smaller in size than fraction 1, was stronger. Fraction 3, composed of Au and up to 3% Cu was noncytotoxic for thymocytes, but was cytotoxic for L929 cells. Fraction 4, composed of Au and Ag nanoparticles, and fraction 5, composed of Au together with Cu, Ni, Zn, Fe, and In were cytotoxic for both thymocytes and L929 cells. These results suggest that USP enables the synthesis of pure gold nanoparticles with controlled size, even from gold scrap. However, microstructural analyses and biocompatibility testing are necessary for their proper selection from more cytotoxic gold nanoparticles, contaminated with other elements of gold alloys.