scholarly journals The Pandemic and Criminal Law – A Look at Theory and Practice in Germany

2021 ◽  
Vol 26 (6) ◽  
pp. 9-26
Author(s):  
Henning Lorenz ◽  
Engin Turhan
Keyword(s):  
Intensive Care ◽  
Criminal Law ◽  
Face Mask ◽  
Theory And Practice ◽  
Legal Certainty ◽  
Risk Of Death ◽  
Infection Protection Act ◽  
Bodily Injury ◽  
German Infection Protection Act ◽  
State Aids

Abstract This article provides an overview of the topic of the pandemic from the perspective of criminal law theory and practice in Germany. First of all, the major criminal offences of bodily injury and murder are discussed in the context of infecting a person with the Coronavirus and the (possible) consequences of having Covid-19, such as risk of death. The dilemmatic situation of triage, i.e., allocating limited intensive care resources, is illustrated in relation to the same offences. Then, the more specific crimes that came to the fore in the course of the pandemic are addressed. Subsidy fraud due to the state aids intended to compensate for the financial damage in the marketplace because of pandemic-related measures, and issuance or use of incorrect health certificates for exemption from the obligation to wear a face mask fall within this scope. Finally, the administrative offences law of the German Infection Protection Act was discussed, primarily with regard to regulations that violate the principle of legal certainty.

scholarly journals Early Prediction of Seven-Day Mortality in Intensive Care Unit Using a Machine Learning Model: Results from the SPIN-UTI Project

2021 ◽  
Vol 10 (5) ◽  
pp. 992
Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Giuliana Favara ◽  
Paolo Marco Riela ◽  
Giovanni Gallo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Learning Algorithm ◽  
Area Under The Curve ◽  
Support Vector ◽  
Icu Admission ◽  
Risk Of Death ◽  
Saps Ii ◽  
Svm Algorithm

Patients in intensive care units (ICUs) were at higher risk of worsen prognosis and mortality. Here, we aimed to evaluate the ability of the Simplified Acute Physiology Score (SAPS II) to predict the risk of 7-day mortality, and to test a machine learning algorithm which combines the SAPS II with additional patients’ characteristics at ICU admission. We used data from the “Italian Nosocomial Infections Surveillance in Intensive Care Units” network. Support Vector Machines (SVM) algorithm was used to classify 3782 patients according to sex, patient’s origin, type of ICU admission, non-surgical treatment for acute coronary disease, surgical intervention, SAPS II, presence of invasive devices, trauma, impaired immunity, antibiotic therapy and onset of HAI. The accuracy of SAPS II for predicting patients who died from those who did not was 69.3%, with an Area Under the Curve (AUC) of 0.678. Using the SVM algorithm, instead, we achieved an accuracy of 83.5% and AUC of 0.896. Notably, SAPS II was the variable that weighted more on the model and its removal resulted in an AUC of 0.653 and an accuracy of 68.4%. Overall, these findings suggest the present SVM model as a useful tool to early predict patients at higher risk of death at ICU admission.

scholarly journals Cardiac biomarkers in acute respiratory distress syndrome: a systematic review and meta-analysis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Dilip Jayasimhan ◽  
Simon Foster ◽  
Catherina L. Chang ◽  
Robert J. Hancox
Keyword(s):  
Systematic Review ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Cardiac Dysfunction ◽  
Distress Syndrome ◽  
Troponin I ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
Cardiac Biomarkers ◽  
Risk Of Death

Abstract Background Acute respiratory distress syndrome (ARDS) is a leading cause of morbidity and mortality in the intensive care unit. Biochemical markers of cardiac dysfunction are associated with high mortality in many respiratory conditions. The aim of this systematic review is to examine the link between elevated biomarkers of cardiac dysfunction in ARDS and mortality. Methods A systematic review of MEDLINE, EMBASE, Web of Science and CENTRAL databases was performed. We included studies of adult intensive care patients with ARDS that reported the risk of death in relation to a measured biomarker of cardiac dysfunction. The primary outcome of interest was mortality up to 60 days. A random-effects model was used for pooled estimates. Funnel-plot inspection was done to evaluate publication bias; Cochrane chi-square tests and I2 tests were used to assess heterogeneity. Results Twenty-two studies were included in the systematic review and 18 in the meta-analysis. Biomarkers of cardiac stretch included NT-ProBNP (nine studies) and BNP (six studies). Biomarkers of cardiac injury included Troponin-T (two studies), Troponin-I (one study) and High-Sensitivity-Troponin-I (three studies). Three studies assessed multiple cardiac biomarkers. High levels of NT-proBNP and BNP were associated with a higher risk of death up to 60 days (unadjusted OR 8.98; CI 4.15-19.43; p<0.00001). This association persisted after adjustment for age and illness severity. Biomarkers of cardiac injury were also associated with higher mortality, but this association was not statistically significant (unadjusted OR 2.21; CI 0.94-5.16; p= 0.07). Conclusion Biomarkers of cardiac stretch are associated with increased mortality in ARDS.

scholarly journals Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience

2021 ◽  
Vol 32 (5) ◽  
pp. 435-443
Author(s):  
Maria Elena Ceballos ◽  
Patricio Ross ◽  
Martin Lasso ◽  
Isabel Dominguez ◽  
Marcela Puente ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
General Population ◽  
Clinical Characteristics ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Viral Load ◽  
Risk Of Death ◽  
Living With Hiv

In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death ( p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07–0.31) and younger age (OR 8.68; IC 95% 2.66–28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05–5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.

scholarly journals Increased Risk of Death, in the Hospital and Outside the Intensive Care Unit, for Patients With Cirrhosis After Cardiac Arrest

2017 ◽  
Vol 15 (11) ◽  
pp. 1808-1810 ◽  
Author(s):  
Megan E. Reinders ◽  
Gabriel Wardi ◽  
Ricki Bettencourt ◽  
Daniel Bouland ◽  
Jessica Bazick ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Risk Of Death ◽  
Increased Risk

scholarly journals Development and validation of the predictive risk of death model for adult patients admitted to intensive care units in Japan: an approach to improve the accuracy of healthcare quality measures

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Hideki Endo ◽  
Shigehiko Uchino ◽  
Satoru Hashimoto ◽  
Yoshitaka Aoki ◽  
Eiji Hashiba ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Generalized Linear Model ◽  
Healthcare Quality ◽  
Brier Score ◽  
Linear Predictor ◽  
Risk Of Death ◽  
Apache Iii ◽  
Funnel Plots

Abstract Background The Acute Physiology and Chronic Health Evaluation (APACHE) III-j model is widely used to predict mortality in Japanese intensive care units (ICUs). Although the model’s discrimination is excellent, its calibration is poor. APACHE III-j overestimates the risk of death, making its evaluation of healthcare quality inaccurate. This study aimed to improve the calibration of the model and develop a Japan Risk of Death (JROD) model for benchmarking purposes. Methods A retrospective analysis was conducted using a national clinical registry of ICU patients in Japan. Adult patients admitted to an ICU between April 1, 2018, and March 31, 2019, were included. The APACHE III-j model was recalibrated with the following models: Model 1, predicting mortality with an offset variable for the linear predictor of the APACHE III-j model using a generalized linear model; model 2, predicting mortality with the linear predictor of the APACHE III-j model using a generalized linear model; and model 3, predicting mortality with the linear predictor of the APACHE III-j model using a hierarchical generalized additive model. Model performance was assessed with the area under the receiver operating characteristic curve (AUROC), the Brier score, and the modified Hosmer–Lemeshow test. To confirm model applicability to evaluating quality of care, funnel plots of the standardized mortality ratio and exponentially weighted moving average (EWMA) charts for mortality were drawn. Results In total, 33,557 patients from 44 ICUs were included in the study population. ICU mortality was 3.8%, and hospital mortality was 8.1%. The AUROC, Brier score, and modified Hosmer–Lemeshow p value of the original model and models 1, 2, and 3 were 0.915, 0.062, and < .001; 0.915, 0.047, and < .001; 0.915, 0.047, and .002; and 0.917, 0.047, and .84, respectively. Except for model 3, the funnel plots showed overdispersion. The validity of the EWMA charts for the recalibrated models was determined by visual inspection. Conclusions Model 3 showed good performance and can be adopted as the JROD model for monitoring quality of care in an ICU, although further investigation of the clinical validity of outlier detection is required. This update method may also be useful in other settings.

Criminal Law Measures: Problems of Theory and Practice (Review of the Materials of the Round Table)

2021 ◽  
pp. 104-108
Author(s):  
Andrianov V. K. ◽  
◽  
Pudovochkin Yu. E. ◽  
Tolkachenko A. A.
Keyword(s):  
Criminal Law ◽  
Round Table ◽  
Theory And Practice ◽  
State University ◽  
Russian State ◽  
Practice Review

The publication presents a report on the All-Russian round table organized by the Center for the Study of Problems of Justice of the Russian State University of Justice and devoted to topical issues of theory and practice of the application of criminal law measures. A summary of the content of the speeches of the participants and the main content of the discussion are presented.

The Social Dangers Of The Crime Of Abuse Of Power Or Position: Problems Of Theory And Practice

2021 ◽  
Vol 03 (02) ◽  
pp. 72-12
Author(s):  
Shukhrat Khodjievich Alirizaev ◽  
Keyword(s):  
Criminal Law ◽  
Public Life ◽  
Criminal Code ◽  
Theory And Practice ◽  
Abuse Of Power ◽  
Official Position ◽  
The Social ◽  
Position Article

The article deals with the theoretical problems of social danger of the crime of abuse of power or official position (Article 205 of the Criminal Code), its place in criminal law, its connection with other official crimes. It also analyzes the increase in this crime in public life, corruption offenses and the origin of crimes. Signs of these and other official crimes are highlighted. Qualification issues in the competition of general and special official crimes are analyzed.

Neutrophil-to-lymphocyte count ratio in predicting prognosis of septic shock patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hoda Omar Mahmoud ◽  
Niven Gerges Fahmy ◽  
Mona Ahmed Mohamed Abdelmotaleb Ammar ◽  
Mostafa Mansour Mohamed Elsaid ELryany
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Lymphocyte Count ◽  
Late Mortality ◽  
Late Death ◽  
Tertiary Referral Center ◽  
Risk Of Death ◽  
Count Ratio ◽  
Significant Difference ◽  
Common Causes

Abstract Background Septic shock is one of the most common causes of admission to the intensive care unit in the world and one of the most common causes of death among intensive care patients. Since the definition of sepsis and septic shock and many studies have been designed to understand everything about sepsis regarding mechanism, pathophysiology, complications, diagnosis, management and all other aspects. Objective To find the association between neutrophil to lymphocyte count ratio and the mortality from septic shock patients. The work aims also to determine if this ratio can be used as a prognostic marker of septic shock patients and to compare this ratio with other sepsis markers as C-reactive protein (CRP) and procalcitonin. Patients and Methods This study was conducted prospectively in critical care unit in Ain Shams Hospital, a university-affiliated, tertiary referral center in Cairo, Egypt. Study subjects included 125 patients between January 2018 to January 2019. The ethics committee of our institution approved the study protocol, and written informed consent was obtained from each patient’s family. Results In our study, the neutrophils count was significantly increased in survived patients compared with early and late mortality patients in day 1 while lymphocytes count was lower in survived patient than early and late mortality patients and the NLCR in our study was higher in survived patients than early and late mortality patients. In day 4, our results revealed significant increase in neutrophils count in patients of late mortality compared with its count in survived patients, while lymphocytes didn't show any significant difference compared with its count in survived patients with significant increase in NLCR in patients of late mortality compared with those of survived patients in day 4. Both CRP and procalcitonin are increased in patients of early and late mortality groups compared with its value in survived patients in day 1 and 4. Conclusion This study demonstrates a real relationship between the NLCR and the risk of death in septic shock patients. Septic shock patients at risk of early death presented a low NLCR at admission, although late death was associated with an increased NLCR during the first 5 days. Early and late death should be distinguished because they may involve different underlying mechanisms, and the NLCR might be considered as a discriminant indicator of early or late death. In addition, our findings provide more insight into biology. The circulating neutrophil and lymphocyte trends observed in this study offer an interesting mechanistic viewpoint. We observed that circulating lymphocytes and the NLCR behave in opposite ways in early- and late death patients, supporting the hypothesis that divergent mechanisms could be involved in these two groups.

scholarly journals Konsepsi Hukum Progresif dalam Pengaturan Tindak Pidana Korupsi di Indonesia

2020 ◽  
Vol 1 (2) ◽  
pp. 35-39
Author(s):  
Efraim Mbomba Reda ◽  
I Nyoman Putu Budiartha ◽  
I Made Minggu Widyantara
Keyword(s):  
Law Enforcement ◽  
Criminal Law ◽  
Role Models ◽  
Research Method ◽  
Criminal Code ◽  
Legal Positivism ◽  
Sociology Of Law ◽  
Legal Certainty ◽  
Legal Research ◽  
Descriptive Method

Progressive law puts forward the sociology of law rather than legal certainty which is the focus of legal positivism. In Indonesia, this law was coined by Satjipto Rahardjo. This study aims to determine the formulation of progressive law in future criminal law, and to determine the actualization of the concept of progressive law in regulating corruption in Indonesia. The research method used is a normative legal research method with statute and conceptual approaches. The technique of collecting legal materials in this study is a descriptive method that aims to obtain the meaning of reality related to the problems to be discussed and solved in this study. The results show that in the current Criminal Code Bill, progressive law has been regulated, to be precise in Article 2 paragraph (1) and (2). Progressive law is also regulated in Law no. 48 of 2009 concerning Judicial Power. Then, the actualization of progressive law in regulating corruption in Indonesia is a judge with the powers that take into account the sociological context of society in making decisions. Judges, prosecutors and lawyers can certainly discuss together in eradicating corruption. Efforts are also being made to reconstruct and redefine the power of law enforcement. This arrangement can also encourage the KPK to be more progressive in eradicating corruption, as well as building law enforcers who have morality so that they can become role models and increase public participation, for example by forming NGOs in preventing or fighting corruption in various agencies.

scholarly journals Association Between Oxygen Partial Pressure Trajectories and Short-Term Outcomes in Patients With Hemorrhagic Brain Injury

2021 ◽  
Vol 8 ◽  
Author(s):  
Guolong Cai ◽  
Weizhe Ru ◽  
Qianghong Xu ◽  
Jiong Wu ◽  
Shijin Gong ◽  
...  
Keyword(s):  
Intensive Care ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Oxygen Partial Pressure ◽  
Partial Pressure ◽  
Medical Information ◽  
Logistic Models ◽  
Neurological Outcomes ◽  
Risk Of Death ◽  
Logistic Analysis

Objectives: Arterial hyperoxia is reportedly a risk factor for poor outcomes in patients with hemorrhagic brain injury (HBI). However, most previous studies have only evaluated the effects of hyperoxia using static oxygen partial pressure (PaO2) values. This study aimed to investigate the association between overall dynamic oxygenation status and HBI outcomes, using longitudinal PaO2 data.Methods: Data were extracted from the Medical Information Mart for Intensive Care III database. Longitudinal PaO2 data obtained within 72 h of admission to an intensive care unit were analyzed, using a group-based trajectory approach. In-hospital mortality was used as the primary outcomes. Multivariable logistic models were used to explore the association between PaO2 trajectory and outcomes.Results: Data of 2,028 patients with HBI were analyzed. Three PaO2 trajectory types were identified: Traj-1 (mild hyperoxia), Traj-2 (transient severe hyperoxia), and Traj-3 (persistent severe hyperoxia). The initial and maximum PaO2 of patients with Traj-2 and Traj-3 were similar and significantly higher than those of patients with Traj-1. However, PaO2 in patients with Traj-2 decreased more rapidly than in patients with Traj-3. The crude in-hospital mortality was the lowest for patients with Traj-1 and highest for patients with Traj-3 (365/1,303, 209/640, and 43/85 for Traj-1, Traj-2, and Traj-3, respectively; p &lt; 0.001), and the mean Glasgow Coma Scale score at discharge (GCSdis) was highest for patients with Traj-1 and lowest in patients with Traj-3 (13 [7–15], 11 [6–15], and 7 [3–14] for Traj-1, Traj-2, and Traj-3, respectively; p &lt; 0.001). The multivariable model revealed that the risk of death was higher in patients with Traj-3 than in patients with Traj-1 (odds ratio [OR]: 3.3, 95% confidence interval [CI]: 1.9–5.8) but similar for patients with Traj-1 and Traj-2. Similarly, the logistic analysis indicated the worst neurological outcomes in patients with Traj-3 (OR: 3.6, 95% CI: 2.0–6.4, relative to Traj-1), but similar neurological outcomes for patients in Traj-1 and Traj-2.Conclusion: Persistent, but not transient severe arterial hyperoxia, was associated with poor outcome in patients with HBI.

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