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Fiscal sustainability and the role of voluntary income tax filing: evidence from Germany : an initial analysis
No full textReporting guideline for Chatbot Health Advice studies: the CHART statement
No full textBackgroundThe Chatbot Assessment Reporting Tool (CHART) is a reporting guideline developed to provide reporting recommendations for studies evaluating the performance of generative artificial intelligence (AI)-driven chatbots when summarizing clinical evidence and providing health advice, referred to as Chatbot Health Advice (CHA) studies.MethodsCHART was developed in several phases after performing a comprehensive systematic review to identify variation in the conduct, reporting, and methodology in CHA studies. Findings from the review were used to develop a draft checklist that was revised through an international, multidisciplinary modified asynchronous Delphi consensus process of 531 stakeholders, three synchronous panel consensus meetings of 48 stakeholders, and subsequent pilot testing of the checklist.ResultsCHART includes 12 items and 39 subitems to promote transparent and comprehensive reporting of CHA studies. These include Title (subitem 1a), Abstract/Summary (subitem 1b), Background (subitems 2ab), Model Identifiers (subitems 3ab), Model Details (subitems 4abc), Prompt Engineering (subitems 5ab), Query Strategy (subitems 6abcd), Performance Evaluation (subitems 7ab), Sample Size (subitem 8), Data Analysis (subitem 9a), Results (subitems 10abc), Discussion (subitems 11abc), Disclosures (subitem 12a), Funding (subitem 12b), Ethics (subitem 12c), Protocol (subitem 12d), and Data Availability (subitem 12e).ConclusionThe CHART checklist and corresponding methodological diagram were designed to support key stakeholders including clinicians, researchers, editors, peer reviewers, and readers in reporting, understanding, and interpreting the findings of CHA studies
Atrial cardiomyopathy: From healthy atria to atrial failure. A clinical consensus statement of the Heart Failure Association of the ESC
No full textThe importance of atrial cardiomyopathy (AtCM) as a specific clinical entity is increasingly recognized. Past definitions have varied, and the lack of consistent cut-offs for imaging parameters and biomarkers have limited clinical utility to diagnose and track AtCM progression. While research has mainly focused on AtCM in the context of atrial fibrillation, emerging evidence underscores its relevance in remodelling and development of heart failure. The aim of this consensus document was to provide a contemporary framework for AtCM, evolve the definitions of AtCM and atrial failure for more widespread clinical use, and help to direct emerging research and future clinical trials. Supporting the work of early career researchers, this consensus document evaluates diagnostic markers and summarizes the underpinning mechanisms, clinical characteristics and prognostic impact of AtCM. Our objective was to bring together new translational scientific progress, catalyse future research and enable clinical application to facilitate better management, for example in patient groups where aggressive control of risk factors or comorbidities could prevent AtCM progression. We redefined AtCM as a graded disorder that includes electrical dysfunction of the atria along with evidence of either mechanical atrial dysfunction, atrial enlargement and/or atrial fibrosis. Atrial failure is the end-stage manifestation of AtCM, characterized by progressive structural, electrophysiological and functional changes. Earlier identification, risk stratification and ongoing research into therapeutic options have the potential to prevent the clinical consequences of AtCM and atrial failure, including adverse patient outcomes and poor quality of life associated with atrial fibrillation and heart failure
Einfluss von Holzzersetzung im Stamminneren auf Bestandsbiomasse und Kohlenstoffvorräte bei alten Fichten und Tannen
No full textIn vivo insights into irregular voice production as a complex nonlinear system : a case study
No full textThe human voice exhibits diverse expressions, primarily generated by the regular oscillatory movement of both vocal folds. However, further vocal tract structures can also oscillate, as observed in different singing styles, supraglottic voice substitutes and functional voice disorders. To describe the spectrum of irregular phonation types from a nonlinear systems perspective, we conducted in vivo investigations with a professional metal singer using transnasal high-speed digital imaging combined with electroglottography and acoustic data. Here, we analysed 10 distinct voice qualities. Some of these show oscillatory mechanisms characterized by nearly periodic patterns that differ in three key aspects: the ratio of glottal to supraglottic oscillations, their behaviour during the glissando and the oscillating structures primarily involved. Both reduced glottal adduction and increased glottal and supraglottic compression contribute to a greater degree of irregularity. The supraglottic oscillations can coexist with various glottal oscillation mechanisms. Based on the in vivo data, we identified various nonlinear phenomena of different categories that include synchronized oscillations with defined frequency ratios, bifurcations, biphonations and chaotic oscillations
Tyrosine kinase 2 inhibition improves clinical and molecular hallmarks in various subtypes of cutaneous lupus
No full textBackgroundCutaneous lupus erythematosus (CLE) is a chronic inflammatory skin disease (ISD) with various clinical subtypes. Though the pathogenesis is not yet fully understood T cell mediated autoimmunity and elevated levels of type 1 interferons are two major factors contributing to the development of cutaneous lesions. Type 1 interferons transduce their signal via TYK2.ObjectiveTo investigate the impact of TYK2 signaling in pre-clinical models of CLE.MethodsCLE skin biopsies were investigated by RNA-seq and immunohistochemistry. T cells isolated from CLE skin biopsies (lesional T cells) were re-stimulated with anti-CD2/anti-CD28 and cytokine release was quantified by ELISA and Luminex. Primary human keratinocytes and three-dimensional skin models were stimulated with IFN-α or lesional T-cell supernatant in presence or absence of the TYK2 inhibitor deucravacitinib followed by RNA-seq. Skin biopsies from different CLE subtypes were treated ex vivo with deucravacitinib followed by qRT-PCR.ResultsBulk RNA sequencing revealed a strong correlation between TYK2 and interface dermatitis (ID), a histological hallmark of CLE. Immunohistochemistry confirmed a high abundance of TYK2 amongst different CLE subtypes. Inhibiting TYK2 reduced inflammation and normalized epidermal impairments in primary human keratinocytes, reconstructed human epidermis and CLE T cells. Ex vivo TYK2 inhibition in CLE skin biopsies reduced IFN-response- and necroptosis-related gene expression. Finally, four patients with different therapy-refractory CLE (acute, subacute, chronic discoid, chilblain CLE) were successfully treated with deucravacitinib.ConclusionIFN-α and T cell derived cytokines both contribute to skin inflammation in CLE. TYK2 inhibition is a promising approach for different subtypes of CLE as it controls inflammation in various pre-clinical models and therapy refractory CLE patients
Transcatheter aortic valve replacement with balloon- versus self-expandable bioprostheses for the treatment of bicuspid aortic valve stenosis
No full textUncovering the understanding of the concept of patient similarity in cancer research and treatment: scoping review
No full textBackground: Patient similarity is a fundamental concept in precision oncology, offering a pathway to personalized medicine by identifying patterns and shared characteristics among patients. This concept enables stratification into clinically meaningful subgroups, prediction of treatment responses, and the tailoring of therapeutic interventions to individual needs. Despite its transformative potential, the definition, measurement, and clinical application of patient similarity remain inconsistently established, creating challenges in its integration into cancer research and clinical practice. Objective: This study aimed to synthesize evidence on the multidimensional concept of patient similarity in cancer research by analyzing its application across different points of possible data types, methodological frameworks, biological contexts, and commonly studied cancer types. Methods: This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) framework and the Joanna Briggs Institute guidelines. A systematic search was conducted across PubMed, MEDLINE, LIVIVO, and Web of Science (covering the period from 1998 to February 2024) and was supplemented by snowball sampling and manual searches. Duplicate records were removed, and study selection was carried out in 3 phases: title and abstract screening, disagreement resolution, and full-text screening. Each step was independently performed by 2 reviewers in Rayyan, with conflicts resolved by a third reviewer. Data extraction was performed using a predefined template to capture methodological approaches, data types, cancer types, and research objectives related to similarity in patients with cancer.Results: This scoping review synthesized evidence from 137 studies, emphasizing the multidimensional concept of patient similarity in cancer research, which integrates diverse data types, methodological frameworks, research objectives, and cancer types. Transcriptomic data (92/137, 67.1%) and clinical data (65/137, 47.4%) were the most frequently used, often combined to enhance the comprehensiveness of similarity analyses. Machine learning (76/137, 55.5%) and network-based approaches (72/137, 52.5%) were prominent methods, reflecting their capacity to handle complex, high-dimensional data and uncover intricate relationships. Cancer subtype identification (70/137, 51.1%) and biomarker discovery (41/137, 29.9%) were the primary research objectives, underscoring the centrality of patient similarity in precision oncology. Breast, lung, and brain cancers were the most frequently studied, benefiting from established research frameworks and abundant datasets. Conversely, rare cancers were underrepresented, highlighting a critical gap in the generalizability of current methodologies.Conclusions: This comprehensive scoping review examines the concept of patient similarity in cancer research and highlights the critical role of a multilayered perspective in capturing its complexity and identification to enhance understanding and application in precision oncolog
