Prognostic Value of Standard Heart Failure Medication in Patients with Cardiac Transthyretin Amyloidosis

Introduction: Cardiac transthyretin amyloidosis (ATTR) is a progressive, fatal disease leading to heart failure due to accumulation of amyloid fibrils in the interstitial space and may occur as a hereditary (ATTRv) or wild-type (ATTRwt) form. Guidelines recommend the use of ACE inhibitors (ACEis) and beta-blockers (BBs) as heart failure therapy (HFT) in all patients with symptomatic heart failure and reduced ejection fraction, independent of the underlying etiology. However, the prognostic benefit of ACEis and BBs in ATTR has not been elucidated in detail yet. We thus sought to retrospectively investigate the outcome of patients with ATTRwt or ATTRv under HFT. Methods: Medical records of 403 patients with cardiac ATTR (ATTRwt: n = 268, ATTRv: n = 135) were screened for long-term medication as well as clinical, laboratory, electrocardiographic and echocardiographic data. Patients were assessed between 2005 and 2020 at the University Hospital Heidelberg. Kaplan-Meier analysis was used to analyze potential differences in survival among different subgroups. Results: The mean follow-up was 28 months. In total, 43 patients (32%) with ATTRv and 140 patients (52%) with ATTRwt received HFT. Survival was significantly shorter in patients receiving HFT in ATTRv (46 vs. 83 months, p = 0.0007) vs. non-HFT. A significantly better survival was observed in patients with comorbidities (coronary artery disease, arterial hypertension) and HFT among ATTRwt patients (p = 0.004). No significant differences in survival were observed in the other subgroups. Conclusions: Survival analysis revealed a potential benefit of HFT in patients with ATTRwt and cardiac comorbidities such as coronary artery disease and/or arterial hypertension. In contrast, HFT should be used with caution in patients with ATTRv.

Time Trends in Causes of Death in People with HIV: Insights from the Swiss HIV Cohort Study

BACKGROUND

Advancements in access to antiretroviral therapy (ART) and human immunodeficiency virus (HIV) care have led to a decline in acquired immunodeficiency syndrome (AIDS)-related deaths among people with HIV (PWH) in Switzerland. However, data on the ongoing changes in causes of death among PWH over the past 15 years is scarce.

METHODS

We investigated all reported deaths in the Swiss HIV Cohort Study between 2005-2022. Causes of death were categorized using the Coding Causes of Death in HIV protocol. The statistical analysis included demographic stratification to identify time trends and logistic regression models to determine associated factors for the underlying cause of death.

RESULTS

In total, 1630 deaths were reported, with 23.7% of individuals assigned female at birth. Out of these deaths, 147 (9.0%) were HIV/AIDS-related, 373 (22.9%) due to non-AIDS, non-hepatic (NANH) cancers, 166 (10.2%) liver-related, and 158 (9.7%) cardiovascular-related. The median age at death increased from 45.0 [40.0,53.0] years in 2005-2007 to 61.0 [56.0,69.5] years in 2020-2022. HIV/AIDS and liver-related causes of death decreased, whereas deaths from NANH cancers increased, and cardiovascular-related deaths remained relatively stable.

CONCLUSION

The proportionally decreasing HIV/AIDS and liver-related deaths showcase the effectiveness of ART, comprehensive HIV patient care, and interventions targeting hepatitis C virus co-infection. Future research should focus on managing cancer and cardiovascular-related conditions as the new leading causes of death among PWH. Comprehensive healthcare strategies focusing on non-AIDS-related comorbidities, cancer management, and sustaining liver and cardiovascular health are needed to bridge the ongoing health disparities between PWH and the general population.

Accurate Bracket Placement with an Indirect Bonding Method Using Digitally Designed Transfer Models Printed in Different Orientations-An In Vitro Study

Objective: A digital workflow opens up new possibilities for the indirect bonding (IDB) of brackets. We tested if the printing orientation for bracket transfer models on the build platform of a 3D printer influences the accuracy of the following IDB method. We also evaluated the clinical acceptability of the IDB method combining digitally planned and printed transfer models with the conventional fabrication of pressure-molded transfer trays. Materials and Methods: In total, 27 digitally planned bracket transfer models were printed with both 15° and 75° angulation from horizontal plane on the build platform of a digital light processing (DLP) printer. Brackets were temporarily bonded to the transfer models and pressure-molded trays were produced on them. IDB was then performed using the trays on the respective plaster models. The plaster models were scanned with an optical scanner. Digitally planned pre-bonding and scanned post-bonding bracket positions were superimposed with a software and resulted in three linear and three angular deviations per bracket. Results: No statistically significant differences of the transfer accuracy of printed transfer models angulated 15° or 75° on the 3D printer build platform were found. About 97% of the linear and 82% of the angular deviations were within the clinically acceptable range of ±0.2 mm and ±1°, respectively. The highest inaccuracies in the linear dimension occurred in the vertical towards the gingival direction and in the angular dimension in palatal crown torque. Conclusion: For the IDB method used, the printing orientation on the build platform did not have a significant impact on the transfer accuracy.

Predictors and Prognostic Implications of Cardiac Arrhythmias in Patients Hospitalized for COVID-19

BACKGROUND

Cardiac manifestation of COVID-19 has been reported during the COVID pandemic. The role of cardiac arrhythmias in COVID-19 is insufficiently understood. This study assesses the incidence of cardiac arrhythmias and their prognostic implications in hospitalized COVID-19-patients.

METHODS

A total of 166 patients from eight centers who were hospitalized for COVID-19 from 03/2020-06/2020 were included. Medical records were systematically analyzed for baseline characteristics, biomarkers, cardiac arrhythmias and clinical outcome parameters related to the index hospitalization. Predisposing risk factors for arrhythmias were identified. Furthermore, the influence of arrhythmia on the course of disease and related outcomes was assessed using univariate and multiple regression analyses.

RESULTS

Arrhythmias were detected in 20.5% of patients. Atrial fibrillation was the most common arrhythmia. Age and cardiovascular disease were predictors for new-onset arrhythmia. Arrhythmia was associated with a pronounced increase in cardiac biomarkers, prolonged hospitalization, and admission to intensive- or intermediate-care-units, mechanical ventilation and in-hospital mortality. In multiple regression analyses, incident arrhythmia was strongly associated with duration of hospitalization and mechanical ventilation. Cardiovascular disease was associated with increased mortality.

CONCLUSIONS

Arrhythmia was the most common cardiac event in association with hospitalization for COVID-19. Older age and cardiovascular disease predisposed for arrhythmia during hospitalization. Whereas in-hospital mortality is affected by underlying cardiovascular conditions, arrhythmia during hospitalization for COVID-19 is independently associated with prolonged hospitalization and mechanical ventilation. Thus, incident arrhythmia may indicate a patient subgroup at risk for a severe course of disease.

The Influence of Regulation on Trust and Risk Preference in Sharing Communities

Sharing within communities has gained popularity in recent years. However, taking part in a community also comes with a certain amount of risk. This perceived amount of risk can be contained by regulations within a community as well as by potential participants' trust in the community and the other members. We argue for a relation between regulation and the willingness to take the risk of joining a sharing community with trust as a mediator. Thereby, we distinguish between two kinds of regulation (soft and harsh regulation) and two kinds of trust (implicit and reason-based trust) on two different levels (vertical and horizontal trust). In one laboratory and one online experiment with 432 participants overall, we found that the compound of high soft and low harsh regulation increases participants' willingness to take the risk of participation and that the effect of soft regulation is mediated mainly by vertical and horizontal reason-based trust. Based on our results, we encourage sharing communities to count on soft regulation in order to increase potential members' trust in the community and therefore take the risk to participate.

Continuous pH monitoring in wounds using a composite indicator dressing - A feasibility study

PURPOSE

Modern burn care strives for new means to guarantee optimised wound healing. Several studies have shown a correlation between the pH value in a (burn) wound and successful wound healing. A multitude of devices to monitor pH is available, all requiring direct wound contact and removal of the dressing for pH monitoring. The aim of this feasibility study was to create a sterile and easy to handle method for pH monitoring while simultaneously using an advanced wound dressing.

MATERIALS AND METHODS

Dressing sheets of biotechnologically generated nanofibrillar cellulose (epicite^hydro) were chemically functionalised with the indicator dye GJM-534. pH-donors with increasing pH were subsequently applied to the created indicator dressing. To investigate temporal resolution and continuous monitoring we used circular pH-donors with different pH (7 and 10) and decreasing diameters that were placed on another dressing sheet. Clinically relevant spatial resolution was checked by a wound bed simulation with small areas (8 mm) of higher pH (10) on a field of lower pH (7) and vice versa.

RESULTS

The indicator dressing showed a gradual colouring from yellow to dark orange with increasing pH in steps of 0.3. After conversion of digital pictures to greyscale values, a sigmoidal distribution with a pK_a-value of 8.4 was obtained. A ring-like pattern with alternating colour change corresponding to the pH was observed in the continuous monitoring experiment and the wound bed simulation delivered excellent local resolution.

CONCLUSION

Since the pH of a (burn) wound can have a significant influence on wound healing, a pH indicator was successfully linked to an advanced, temporary, alloplastic wound dressing material. We were able to show the possibility of pH monitoring by the dressing itself. Additional testing, including studies with large case numbers for optimisation are necessary before clinical implementation.

The Relationship Between Austrian Tax Auditors and Self-Employed Taxpayers: Evidence From a Qualitative Study

A constructive, highly professional relationship between tax authorities and taxpayers is essential for tax compliance. The aim of the present paper was to explore systematically the determinants of this relationship and related tax compliance behaviors based on the extended slippery slope framework. We used in-depth qualitative interviews with 33 self-employed taxpayers and 30 tax auditors. Interviewees described the relationship along the extended slippery slope framework concepts of power and trust. However, also novel sub-categories of power (e.g., setting deadlines) and trust (e.g., personal assistance) were mentioned. Furthermore, also little-studied categories of tax behavior emerged, such as accepting tax behavior, e.g., being available to the tax authorities, or stalling tax behavior, e.g., the intentional creation of complexity. The results comprehensively summarize the determinants of the tax relationship and tax compliance behaviors. Additionally, results highlight future research topics and provide insights for policy strategies.

The impact of powerful authorities and trustful taxpayers: evidence for the extended slippery slope framework from Austria, Finland, and Hungary

Tax authorities utilize a wide range of instruments to motivate honest taxpaying ranging from strict audits to fair procedures or personalized support, differing from country to country. However, little is known about how these different instruments and taxpayers' trust influence the generation of interaction climates between tax authorities and taxpayers, motivations to comply, and particularly, tax compliance. The present research examines the extended slippery slope framework (eSSF), which distinguishes tax authorities' instruments into different qualities of power of authority (coercive and legitimate) and trust in authorities (reason-based and implicit), to shed light on the effect of differences between power and trust. We test eSSF assumptions with survey data from taxpayers from three culturally different countries (N = 700) who also vary concerning their perceptions of power, trust, interaction climates, and tax motivations. Results support assumptions of the eSSF. Across all countries, the relation of coercive power and tax compliance was mediated by implicit trust. The connection from legitimate power to tax compliance is partially mediated by reason-based trust. The relationship between implicit trust and tax compliance is mediated by a confidence climate and committed cooperation. Theoretical and practical implications are discussed.

Chalcogenide substitution in the [2Fe] cluster of [FeFe]-hydrogenases conserves high enzymatic activity

[FeFe]-Hydrogenases efficiently catalyze the uptake and evolution of H₂ due to the presence of an inorganic [6Fe-6S]-cofactor (H-cluster). This cofactor is comprised of a [4Fe-4S] cluster coupled to a unique [2Fe] cluster where the catalytic turnover of H₂/H⁺ takes place. We herein report on the synthesis of a selenium substituted [2Fe] cluster [Fe₂{μ(SeCH₂)₂NH}(CO)₄(CN)₂]^2- (ADSe) and its successful in vitro integration into the native protein scaffold of [FeFe]-hydrogenases HydA1 from Chlamydomonas reinhardtii and CpI from Clostridium pasteurianum yielding fully active enzymes (HydA1-ADSe and CpI-ADSe). FT-IR spectroscopy and X-ray structure analysis confirmed the presence of structurally intact ADSe at the active site. Electrochemical assays reveal that the selenium containing enzymes are more biased towards hydrogen production than their native counterparts. In contrast to previous chalcogenide exchange studies, the S to Se exchange herein is not based on a simple reconstitution approach using ionic cluster constituents but on the in vitro maturation with a pre-synthesized selenium-containing [2Fe] mimic. The combination of biological and chemical methods allowed for the creation of a novel [FeFe]-hydrogenase with a [2Fe2Se]-active site which confers individual catalytic features.

Coercive and legitimate authority impact tax honesty: evidence from behavioral and ERP experiments

Cooperation in social systems such as tax honesty is of central importance in our modern societies. However, we know little about cognitive and neural processes driving decisions to evade or pay taxes. This study focuses on the impact of perceived tax authority and examines the mental chronometry mirrored in ERP data allowing a deeper understanding about why humans cooperate in tax systems. We experimentally manipulated coercive and legitimate authority and studied its impact on cooperation and underlying cognitive (experiment 1, 2) and neuronal (experiment 2) processes. Experiment 1 showed that in a condition of coercive authority, tax payments are lower, decisions are faster and participants report more rational reasoning and enforced compliance, however, less voluntary cooperation than in a condition of legitimate authority. Experiment 2 confirmed most results, but did not find a difference in payments or self-reported rational reasoning. Moreover, legitimate authority led to heightened cognitive control (expressed by increased MFN amplitudes) and disrupted attention processing (expressed by decreased P300 amplitudes) compared to coercive authority. To conclude, the neuronal data surprisingly revealed that legitimate authority may led to higher decision conflict and thus to higher cognitive demands in tax decisions than coercive authority.

Veränderungen an Vulva und Vestibulum bei Mutterkühen und Färsen in den letzten sieben Tagen vor der Geburt

Gegenstand und Ziel: Ziel dieser Untersuchung war zu überprüfen, inwiefern die Ödematisierung der Vulva, Austritt von Sekret aus der Rima vulvae unddie Veränderung der Schleimhautfarbe im Vestibulum dazu geeignet sind, bei Mutterkühen den genauen Geburtszeitpunktzu bestimmen. Weiterhin sollte die Frage beantwortetwerden,ob ein Rasse- und ein Paritätseinfluss auf diese Parameter bestehen. Material und Methoden: An 105 Tieren (10 Färsen; 95 Kühe, davon 68 Fleckvieh-Kühe und 27 Kreuzungstiere Fleckvieh x Limousin) wurden während der letzten 168 Stunden ante partum alle acht Stunden folgende Merkmale untersucht: Grad der Vulvaödematisierung, Schleimaustritt aus der Rima vulvae und Farbe der Vestibu- larschleimhaut. Ergebnisse: Alle Tiere zeigten eine ÖdematisierteVulva. DerAnteilvon Tieren mit hochgradiger Ödematisierung nahm mit nahender Geburt zu (p <0,001). Zwischen Kühen und Färsen sowie den Rassen ließ sich kein Unterschied nachweisen. Mit zeitlicher Annäherung an den Partus erhöhte sich derAn- teil der Tiere mit Schleimaustritt aus der Rima vulvae nicht (p >0,05). Die Intensitätdes Schleimaustritts war bei Kühen stärker alsbei Färsen (p < 0,05). Rasseunterschiede bestanden nicht. Statistisch signifikante Veränderungen der Schleimhautfarbe des Vestibulums konnten nicht festgestellt werden. Zwischen Kühen und Färsen und zwischen den Rassen fanden sich keine Unterschiede. Schlussfolgerung und klinische Relevanz: Der Grad der Vulvaödematisierung zeigt eine starke zeitliche Bindung zum Abkalbetermin. Sie ist jedoch nicht dazu geeignet,den Zeitpunktdes Partus genauer zu terminieren. Keine zeitliche Bindung besteht zwischen der Veränderung der Vestibularschleimhautfarbe sowie dem Austritt vonSchleimaus der Rima vulvae in der letzten Woche ante partum und dem Geburtszeitpunkt.

Authorities' Coercive and Legitimate Power: The Impact on Cognitions Underlying Cooperation

The execution of coercive and legitimate power by an authority assures cooperation and prohibits free-riding. While coercive power can be comprised of severe punishment and strict monitoring, legitimate power covers expert, and informative procedures. The perception of these powers wielded by authorities stimulates specific cognitions: trust, relational climates, and motives. With four experiments, the single and combined impact of coercive and legitimate power on these processes and on intended cooperation of n1 = 120, n2 = 130, n3 = 368, and n4 = 102 student participants is investigated within two exemplary contexts (tax contributions, insurance claims). Findings reveal that coercive power increases an antagonistic climate and enforced compliance, whereas legitimate power increases reason-based trust, a service climate, and voluntary cooperation. Unexpectedly, legitimate power is additionally having a negative effect on an antagonistic climate and a positive effect on enforced compliance; these findings lead to a modification of theoretical assumptions. However, solely reason-based trust, but not climate perceptions and motives, mediates the relationship between power and intended cooperation. Implications for theory and practice are discussed.

Artifacts in orthodontic bracket systems in cone-beam computed tomography and multislice computed tomography

OBJECTIVES

The purpose of this study was to quantify artifacts caused by different bracket systems in cone-beam computed tomography (CBCT) and multislice computed tomography (MSCT) scans.

METHODS

Orthodontic brackets of four different systems were consecutively bonded to the surface of a residual molar on a human cadaveric mandible. One MSCT system and three CBCT units were used to scan each of the four bonded brackets, in addition to obtaining a blank reference scan of the tooth surface. All datasets were registered to the reference dataset using visualization software (Analyze 11.0® by AnalyzeDirect). Artifact-related reductions in image quality were expressed in percent of theoretical maximum standard deviations (SD) obtained for the gray values of the adjacent voxels, with higher percentages correlating more pronounced artifacts.

RESULTS

Both the SD percentages for three defined line profiles and their mean values were almost invariably higher with the MSCT system than with the CBCT units. Looking into the individual SD percentages, two of the CBCT units (Pax Zenith 3D® and Picasso Trio®; both Vatech) produced higher values than the MSCT system (SOMATOM Definition AS+®; Siemens) in some line profiles. The titanium bracket, in particular, was associated with marked differences between the two scanner technologies, as the mean artifact intensities from this bracket were particularly high with the MSCT unit and relatively low with the CBCT units. The artifact intensities observed with the other three bracket systems varied widely depending on which scanner was used.

CONCLUSION

Different artifact intensities were noted depending on the composition of the bracket system and on the scanner technology (MSCT/CBCT). While the artifacts manifested themselves differently with different scanners, their adverse effects were comparable. However, given the variable severity of the artifacts observed depending on the materials scanned and the scanners used, a blanket recommendation for or against MSCT or CBCT units cannot be given on the basis of this study.

A structural view of synthetic cofactor integration into [FeFe]-hydrogenases

Crystal structures of semisynthetic [FeFe]-hydrogenases with variations in the [2Fe] cluster show little structural differences despite strong effects on activity.

[FeFe]-hydrogenases are nature's fastest catalysts for the evolution or oxidation of hydrogen. Numerous synthetic model complexes for the [2Fe] subcluster (2Fe_H) of their active site are known, but so far none of these could compete with the enzymes. The complex Fe₂[μ-(SCH₂)₂X](CN)₂(CO)₄^2– with X = NH was shown to integrate into the apo-form of [FeFe]-hydrogenases to yield a fully active enzyme. Here we report the first crystal structures of the apo-form of the bacterial [FeFe]-hydrogenase CpI from Clostridium pasteurianum at 1.60 Å and the active semisynthetic enzyme, CpI^ADT, at 1.63 Å. The structures illustrate the significant changes in ligand coordination upon integration and activation of the [2Fe] complex. These changes are induced by a rigid 2Fe_H cavity as revealed by the structure of apoCpI, which is remarkably similar to CpI^ADT. Additionally we present the high resolution crystal structures of the semisynthetic bacterial [FeFe]-hydrogenases CpI^PDT (X = CH₂), CpI^ODT (X = O) and CpI^SDT (X = S) with changes in the headgroup of the dithiolate bridge in the 2Fe_H cofactor. The structures of these inactive enzymes demonstrate that the 2Fe_H-subcluster and its protein environment remain largely unchanged when compared to the active enzyme CpI^ADT. As the active site shows an open coordination site in all structures, the absence of catalytic activity is probably not caused by steric obstruction. This demonstrates that the chemical properties of the dithiolate bridge are essential for enzyme activity.

Does the sole description of a tax authority affect tax evasion?--the impact of described coercive and legitimate power

Following the classic economic model of tax evasion, taxpayers base their tax decisions on economic determinants, like fine rate and audit probability. Empirical findings on the relationship between economic key determinants and tax evasion are inconsistent and suggest that taxpayers may rather rely on their beliefs about tax authority’s power. Descriptions of the tax authority’s power may affect taxpayers’ beliefs and as such tax evasion. Experiment 1 investigates the impact of fines and beliefs regarding tax authority’s power on tax evasion. Experiments 2-4 are conducted to examine the effect of varying descriptions about a tax authority’s power on participants’ beliefs and respective tax evasion. It is investigated whether tax evasion is influenced by the description of an authority wielding coercive power (Experiment 2), legitimate power (Experiment 3), and coercive and legitimate power combined (Experiment 4). Further, it is examined whether a contrast of the description of power (low to high power; high to low power) impacts tax evasion (Experiments 2-4). Results show that the amount of fine does not impact tax payments, whereas participants’ beliefs regarding tax authority’s power significantly shape compliance decisions. Descriptions of high coercive power as well as high legitimate power affect beliefs about tax authority’s power and positively impact tax honesty. This effect still holds if both qualities of power are applied simultaneously. The contrast of descriptions has little impact on tax evasion. The current study indicates that descriptions of the tax authority, e.g., in information brochures and media reports, have more influence on beliefs and tax payments than information on fine rates. Methodically, these considerations become particularly important when descriptions or vignettes are used besides objective information.

Imaging the Parasinus Region with a Third-Generation Dual-Source CT and the Effect of Tin Filtration on Image Quality and Radiation Dose

BACKGROUND AND PURPOSE

CT is the imaging technique of choice in the evaluation of midface trauma or inflammatory disease. We performed a systematic evaluation of scan protocols to optimize image quality and radiation exposure on third-generation dual-source CT.

MATERIALS AND METHODS

CT protocols with different tube voltage (70-150 kV), current (25-300 reference mAs), prefiltration, pitch value, and rotation time were systematically evaluated. All images were reconstructed with iterative reconstruction (Advanced Modeled Iterative Reconstruction, level 2). To individually compare results with otherwise identical factors, we obtained all scans on a frozen human head. Conebeam CT was performed for image quality and dose comparison with multidetector row CT. Delineation of important anatomic structures and incidental pathologic conditions in the cadaver head was evaluated.

RESULTS

One hundred kilovolts with tin prefiltration demonstrated the best compromise between dose and image quality. The most dose-effective combination for trauma imaging was Sn100 kV/250 mAs (volume CT dose index, 2.02 mGy), and for preoperative sinus surgery planning, Sn100 kV/150 mAs (volume CT dose index, 1.22 mGy). "Sn" indicates an additional prefiltration of the x-ray beam with a tin filter to constrict the energy spectrum. Exclusion of sinonasal disease was possible with even a lower dose by using Sn100 kV/25 mAs (volume CT dose index, 0.2 mGy).

CONCLUSIONS

High image quality at very low dose levels can be achieved by using a Sn100-kV protocol with iterative reconstruction. The effective dose is comparable with that of conventional radiography, and the high image quality at even lower radiation exposure favors multidetector row CT over conebeam CT.

Cone beam computed tomography and low-dose multislice computed tomography in orthodontics and dentistry: a comparative evaluation on image quality and radiation exposure

OBJECTIVES

The goal of the present work was to assess various computed tomography (CT) systems in term of image quality and organ doses, namely five cone-beam CT (CBCT) scanners operated at standard settings and three multislice CT (MSCT) scanners operated at greatly dose-reduced settings.

MATERIALS AND METHODS

Radiographic volume scans were taken on a complete human cadaveric head specimen and the image quality of each was rated by four experienced examiners according to specific skeletal structures and bone-soft tissue interfaces. Radiation doses were captured by a head-and-neck phantom (Rando; Alderson Research Laboratories). Standard protocols were used for the CBCT scans. For the MSCT scans, tube voltage and current were adjusted to minimize radiation without compromising image quality.

RESULTS

Interobserver agreement was close to perfect, with iota coefficients of 0.931 (95% CI 0.807-0.978) between groups 1 and 2 and 0.959 (95% CI 0.869-1.000) between groups 1 and 3. Ratings of image quality in terms of skeletal-structure representation were slightly better for the CBCT than the MSCT scanners, although these differences were not statistically significant. The two groups of scanners applied considerably different organ doses: the lowest dose (0.03 mSv) was measured on the bone surface with a CBCT unit (Picasso Trio® from Vatech) and the highest dose (8.30 mSv) in the vicinity of the eye lens with another CBCT unit (3D Accuitomo 170® from J. Morita).

CONCLUSION

The various systems tested offer similar imaging quality but demonstrated distinct differences in organ dose levels. The decision on which approach to take is not between CBCT and MSCT but rather between specific models and parameter settings. If these are optimized, MSCT images providing useful clinical information can be obtained at much reduced levels of radiation. Depending on the model and setting used, MSCT radiation levels may even be lower than during CBCT scans.

Enhancing Tax Compliance through Coercive and Legitimate Power of Tax Authorities by Concurrently Diminishing or Facilitating Trust in Tax Authorities

Both coercion, such as strict auditing and the use of fines, and legitimate procedures, such as assistance by tax authorities, are often discussed as means of enhancing tax compliance. However, the psychological mechanisms that determine the effectiveness of each strategy are not clear. Although highly relevant, there is rare empirical literature examining the effects of both strategies applied in combination. It is assumed that coercion decreases implicit trust in tax authorities, leading to the perception of a hostile antagonistic tax climate and enforced tax compliance. Conversely, it is suggested that legitimate power increases reason-based trust in the tax authorities, leading to the perception of a service climate and eventually to voluntary cooperation. The combination of both strategies is assumed to cause greater levels of intended compliance than each strategy alone. We conducted two experimental studies with convenience samples of 261 taxpayers overall. The studies describe tax authorities as having low or high coercive power (e.g., imposing lenient or severe sanctions) and/or low or high legitimate power (e.g., having nontransparent or transparent procedures). Data analyses provide supportive evidence for the assumptions regarding the impact on intended tax compliance. Coercive power did not reduce implicit trust in tax authorities; however, it had an effect on reason-based trust, interaction climate, and intended tax compliance if applied solely. When wielded in combination with legitimate power, it had no effect.

Effects of supervision on tax compliance: Evidence from a field experiment in Austria

We conduct a field experiment on tax compliance, focusing on newly founded firms. As a novelty the effect of tax authorities' supervision on timely tax payments is examined. Interestingly, results show no positive overall effect of close supervision on tax compliance.

Metric precision via soft-tissue landmarks in three-dimensional structured-light scans of human faces

OBJECTIVES

The goal of the current work was to investigate the suitability of ten facial soft-tissue landmarks (trichion, glabella, nasion, left and right orbital, subnasal, left and right porion, pogonion, gnathion) as reference points for metric facial analysis by analyzing their intra- and interserial precision in all three dimensions.

METHODS

The faces of 32 volunteers were scanned using a standardized protocol with a structured-light scanner (FaceSCAN(3D) Scientific Photolab 60 Hz; 3D Shape, Erlangen, Germany). Three examiners placed the landmarks twice within a 2-week interval. Image processing (Onyx Ceph(3); Image Instruments; Chemnitz, Germany) and statistical (SAS 9.2; SAS Institute, Cary, NC, USA) software was used for analysis. All measurements were corrected for mean values per patient and analyzed for intraserial and interserial error by model II ANOVA for a simple classification with random effects.

RESULTS

Median intraserial precision was 0.40 mm (range 0.05-1.01 mm) overall, including 0.40 mm (0.33-0.85 mm) on the x-axis, 0.64 mm (0.36-0.87 mm) on the y-axis, and 0.27 mm (0.05-1.01 mm) on the z-axis. Interserial precision was substantially lower at a median of 0.05 mm (0-0.22 mm), often not statistically assessable with intraserial precision. We observed no landmark-associated differences; in particular, the medians of the bilateral landmarks orbital (intraserial: 0.40 mm; interserial: 0.02 mm) and porion (intraserial: 0.36 mm; interserial: small and not assessable) were in the middle of the range of our results. Trichion (intraserial: 0.73 mm; interserial: 0.05 mm) and gnathion (intraserial: 0.87 mm; interserial: 0.20 mm) revealed the highest degrees of intraserial measurement imprecision. Outliers were identified in 1.2% (64 of 5400) of measurements.

CONCLUSION

All selected landmarks offer suitably high levels of intra- and interserial precision for the three-dimensional (3D) metric assessment of facial soft-tissue parameters. No difference between (bi)lateral and facial midline landmarks was noted.

[Cerebral venous thrombosis and subdural haematoma: complications of spontaneous intracranial hypotension]

We report on the case of a spontaneous intracranial hypotension with subdural hygroma, as well as cerebral venous thrombosis (CVT), both known complications of intracranial hypotension. The 45-year-old patient was subsequently treated - according to current guidelines for CVT - with anticoagulation, but developed subdural haematoma (SDH), which required neurosurgical treatment. Our case highlights the complex pathophysiological sequelae of intracranial hypotension, as well as the occasionally difficult treatment decisions. Subdural hygroma probably predisposes patients to SDH during anticoagulation. Thus, the potential benefit of anticoagulation needs to be weighed against the risk of SDH on an individual basis.