418 research outputs found
Viral Infections in the Intensive Care Unit
No full textAcute viral infections are a common reason for admission to the Intensive Care Unit (ICU). Among them, human immunodeficiency virus (HIV), influenza, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and herpesviruses are most frequently reported in critically ill setting, leading to potential life-threatening complications. Although combined antiretroviral therapy (ART) and adequate medical care have substantially improved the prognosis of HIV infection, opportunistic infections and other complications may require organ support in the ICU. Vaccination strategies and improved specific therapy may improve the outcomes of SARS-CoV-2 and influenza infections, but the cornerstone of therapy remains supportive care of acute respiratory distress syndrome (ARDS). The herpesviruses family also plays an important role in the ICU, causing encephalitis, pneumonia, gastrointestinal involvement, and skin lesions. Immunosuppressed patients are more susceptible to complicated viral infections, and these viruses may reactivate in patients with a state of immunoparalysis, which is at higher risk of unfavorable outcomes. The aim of this chapter is to briefly characterize the most common viral infections in the ICU, their management, and treatment
K-Means Cluster Analysis: A Precision Stratification Approach for ICU Rehabilitation Research (Motivated by the Study on Individualized Mobilization Dosing in Critically Ill Patients by Fuest et al.)
No full textCluster analysis has emerged as a powerful methodological tool for understanding clinical heterogeneity in observational research. This report demonstrates the application of k-means clustering to critically ill patients in the intensive care unit, motivated by the study by Fuest et al. on individualized mobilization strategies. Using a high-dimensional dataset including age, frailty, illness severity, and functional status, the study segmented patients into four clinically meaningful groups: severely ill and frail, middle-aged, young trauma, and old non-frail. Each group showed distinct mobilization patterns and discharge outcomes, emphasizing the importance of personalized approaches in rehabilitation. For example, early mobilization was particularly beneficial in the young trauma and middle-aged groups, while achieving higher mobilization levels was more relevant for older and frail patients. The report also details the dataset requirements, statistical techniques, and interpretive tools used to ensure valid and reproducible clustering. Tables and visualizations, including PCA plots and elbow curves, support the identification and differentiation of clusters. While cluster analysis offers advantages in stratification and treatment tailoring, it also presents challenges related to variable selection and reproducibility. Overall, this analysis underscores the value of data-driven subgrouping in advancing precision care and highlights future directions for refining cluster-based methodologies in critical care research
K-Means Cluster Analysis: A Precision Stratification Approach for ICU Rehabilitation Research (Motivated by the Study on Individualized Mobilization Dosing in Critically Ill Patients by Fuest et al.)
No full textCluster analysis has emerged as a powerful methodological tool for understanding clinical heterogeneity in observational research. This report demonstrates the application of k-means clustering to critically ill patients in the intensive care unit, motivated by the study by Fuest et al. on individualized mobilization strategies. Using a high-dimensional dataset including age, frailty, illness severity, and functional status, the study segmented patients into four clinically meaningful groups: severely ill and frail, middle-aged, young trauma, and old non-frail. Each group showed distinct mobilization patterns and discharge outcomes, emphasizing the importance of personalized approaches in rehabilitation. For example, early mobilization was particularly beneficial in the young trauma and middle-aged groups, while achieving higher mobilization levels was more relevant for older and frail patients. The report also details the dataset requirements, statistical techniques, and interpretive tools used to ensure valid and reproducible clustering. Tables and visualizations, including PCA plots and elbow curves, support the identification and differentiation of clusters. While cluster analysis offers advantages in stratification and treatment tailoring, it also presents challenges related to variable selection and reproducibility. Overall, this analysis underscores the value of data-driven subgrouping in advancing precision care and highlights future directions for refining cluster-based methodologies in critical care research
Welfare Effects of Immigration in a Dual Labor Market
No full textThe paper analyses the welfare effects of immigration when some sectors of the economy are characterized by wage bargaining between unions and employers. We show that immigration is unambiguously beneficial if the wage elasticity of labor demand in the competitive sectors is smaller than in the unionised sectors. In the opposite case, the welfare effect of immigrat ion is ambiguous; little immigration then reduces the native population's welfare, whereas large scale immigration tends to enhance welfare.Immigration policy, trade unions, welfare
Corporate Tax Policy, Foreign Firm Ownership and Thin Capitalization
No full textThis paper analyzes the implications of foreign firm ownership and international profit shifting through thin capitalization for corporate tax policy. We consider a model of interjurisdictional tax competition where the corporate tax serves as a backstop to the personal income tax, interest on debt is deductible from the corporate tax base and multinational firms may shift profit across countries through thin capitalization. We show that the problem of thin capitalization induces countries to reduce their corporate tax rates below the personal income tax rate and to broaden their tax bases. Moreover, foreign firm ownership leads to a reduction in corporate tax rates. We also show that there is scope for welfare enhancing tax coordination in our model. In the presence of both foreign firm ownership and thin capitalization, countries gain from a coordinated increase in corporate tax rates or from a coordinated broadening of the tax base.tax competition, income shifting
A Theory of User-Fee Competition
No full textWe develop a two-region model where the decentralized provision of spillover goods can be financed by means of taxes or user fees. In order to enforce the fees regions have to invest in exclusion. We show that a decentralized solution tends to be inefficient. There will be over-investment in exclusion and an underprovision of the spillover goods compared to a centralized solution. In addition the regions have strategic incentives to set user charges. If the regional spillover goods are substitutes user fees tend to be inefficiently low, whereas they tend to be inefficiently high if the spillover goods are complements.public goods, club goods, user fees, fiscal federalism
Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study (Intensive Care Medicine, (2022), 48, 6, (690-705), 10.1007/s00134-022-06705-1)
No full textPublisher Copyright: © 2022 The Author(s).In the original version of this article, the given and family names of Kristina Fuest, Tobias Lahmer, Johannes Herrmann, Patrick Meybohm, Nikolaos Markou, Georgia Vasileiadou were incorrectly structured. The Publisher apologises for this mistake.publishersversionpublishe
Tax Competition and Profit Shifting: On the Relationship between Personal and Corporate Tax Rates
No full textThe residence-based taxation of interest income in the EU faces the difficulty that taxpayers may evade taxation by holding bank accounts in other countries. The EU therefore makes considerable efforts to achieve cooperation among EU member states in order to improve tax enforcement. The present paper argues that international cooperation in tax enforcement may not be sufficient to implement an effective taxation of interest income. The reason is that taxpayers may also avoid income taxes by holding financial assets in the corporate sector. If corporate tax competition reduces corporate income tax rates below personal income tax rates, taxpayers will increasingly shift income from the personal to the corporate sphere. We show that this type of income shifting is empirically important. According to our results, a one percentage point increase in the personal income tax rate increases the fraction of private savings held within corporations by approximately 2.6 percentage points.
Capital Mobility and Tax Competition: A Survey
No full textThis paper surveys the literature on the implications of international capital mobility for national tax policies. Our main issue for consideration in this survey is whether taxation of income, specifically capital income will survive, how border crossing investment is taxed relative to domestic investment and whether welfare gains can be achieved through international tax coordination. We develop a a “working horse model” of multinational investment which allows to derive many of the key results from the literature on international taxation in a unified framework. Moreover, we put special emphasis on the problem of tax competition and financial arbitrage.tax competition, capital mobility, tax policy
Wirtschaftliche Freiheit in den deutschen Bundesländern 2010
No full text1. In dieser Studie stellen wir zwei Indizes wirtschaftlicher Freiheit für die deutschen Bundesländer vor. Grundlage sind bis zu zehn Indikatoren verschiedener wirtschaftlicher Kenngrößen, die den staatlichen Einfluss auf die Wirtschaft kennzeichnen. Der L-Index wirtschaftlicher Freiheit bezieht sich auf die alten Bundesländer und deckt den Zeitraum 1970 bis 2008 ab. Er stützt sich auf acht der zehn Indikatoren. Der umfassendere K-Index wirtschaftlicher Freiheit bezieht zudem die neuen Bundesländer ein; ihm liegen alle zehn Indikatoren im Zeitraum von 1994 bis 2008 zugrunde.
2. Bayern und Baden-Württemberg führen in beiden Indizes die Rangliste der wirtschaftlichen Freiheit der Bundesländer an. Die neuen Bundesländer ordnen sich im K-Index am unteren Ende der Rangliste ein; angesichts der unterdurchschnittlichen Wirtschaftsleistung mischt sich der Staat dort vergleichsweise besonders stark in die Wirtschaft ein. Berlin liegt in beiden Vergleichen am Ende der Skala.
3. In den alten Bundesländern war gemäß des L-Index die wirtschaftliche Freiheit im Jahr 1970 am größten. Bis zur Mitte der siebziger Jahre verschlechterte sich die wirtschaftliche Freiheit drastisch. Bis heute haben sich davon die meisten der alten Bundesländer nicht vollständig erholt.
4. Nach unserer Analyse geht mehr wirtschaftliche Freiheit Hand in Hand mit einem höheren Pro-Kopf-Einkommen, mit einem stärkeren Wirtschafts-wachstum und mit einer niedrigeren Arbeitslosigkeit
- …
