Middle-income tax rates: trends and prospects

The federal tax liabilities of different income groups change constantly in response to new tax laws and shifting economic circumstances. For example, in recent years, Congress has lowered individual income tax rates, increased child and dependent care credits, and reduced taxes on dividends and capital gains. Much of the economic analysis and political debate about these federal tax changes concerns the impact on upper- or lower-income groups, while the impact on middle-income taxpayers sometimes gets forgotten. ; The trends in tax rates can be difficult for middle-income taxpayers, themselves, to discern. Modest revisions to the federal tax code may hardly be noticed in any given year; yet these revisions could build over time into a large change in the middle-income tax rate. Some taxpayers may also find it difficult to determine whether changes in their tax liability are due to legislated changes in the federal tax code or shifts in their own circumstances. ; Davig and Garner define the effective federal tax rate for middle-income households and discuss the problems in computing this measure. They find that the effective federal tax rate facing middle-income households has trended downward over the last 25 years and is currently low by historical standards. Moreover, the composition of middle-income tax liabilities over this period has shifted away from individual income taxes toward payroll taxes. Finally, they show that under current tax law middle-income taxes are projected to rise in the future.Taxation

The relationship between patient volume and mortality in NSW major trauma service hospitals

Introduction: Conventional wisdom is that Major Trauma Services (MTS) treating larger volumes of severe trauma patients will have better outcomes than lower volume centres, but recent studies from Europe have questioned this relationship. We aimed to determine if there is a relationship between patient volume and outcome in New South Wales (NSW) MTS hospitals. Materials and Methods: Retrospective observational study using data from the NSW State Trauma Registry from 2010 to 2019 inclusive. Adult patients with Injury Severity Score &gt;15 transported directly to a NSW MTS were included. Outcome measures were mortality at hospital discharge, and intensive care unit and hospital length of stay. Generalised estimating equation models were created to determine the adjusted relationship between patient volume and the main outcome measures. Results: The mean annual patient volume of the MTS ranged from 127.4 to 282.0 patients whilst the observed mortality rates p.a. ranged from 10.4 % to 17.19 %. Multivariate analysis, using low volume MTS as the reference, did not demonstrate a significant difference in mortality between high and low volume MTS (adjusted OR: 1.14 95 % CI: 0.98–1.25, P = 0.087). There was however a significant correlation between volume and length of hospital stay (adjusted β; 0.024, 95 % CI, 0.182 – 1.089, P = 0.006). Conclusions: There was no mortality difference between high and low volume MTS demonstrated. Length of hospital stay significantly increased with increasing volume however.</p

Phenyl Saligenin Phosphate Induced Caspase-3 and c-Jun N-Terminal Kinase Activation in Cardiomyocyte-Like Cells

At present, little is known about the effect(s) of organophosphorous compounds (OPs) on cardiomyocytes. In this study we have investigated the effects of phenyl saligenin phosphate (PSP), two organophosphorothioate insecticides (diazinon and chlorpyrifos) and their acutely toxic metabolites (diazoxon and chlorpyrifos oxon) on mitotic and differentiated H9c2 cardiomyoblasts. OP-induced cytotoxicity was assessed by monitoring MTT reduction, LDH release and caspase-3 activity. Cytotoxicity was not observed with diazinon, diazoxon or chlorpyrifos oxon (48 h exposure; 200 μM). Chlorpyrifos-induced cytotoxicity was only evident at concentrations >100 μM. In marked contrast, PSP displayed pronounced cytotoxicity towards mitotic and differentiated H9c2 cells. PSP triggered the activation of JNK1/2, but not ERK1/2, p38 MAPK or PKB, suggesting a role for this pro-apoptotic protein kinase in PSP-induced cell death. The JNK1/2 inhibitor SP 600125 attenuated PSP-induced caspase-3 and JNK1/2 activation, confirming the role of JNK1/2 in PSP-induced cytotoxicity. Fluorescently labelled PSP (dansylated PSP) was used to identify novel PSP binding proteins. Dansylated PSP displayed cytotoxicity towards differentiated H9c2 cells. 2D-gel electrophoresis profiles of cells treated with dansylated PSP (25 μM) were used to identify proteins fluorescently labelled with dansylated PSP. Proteomic analysis identified tropomyosin, heat shock protein β-1 and nucleolar protein 58 as novel protein targets for PSP. In summary, PSP triggers cytotoxicity in differentiated H9c2 cardiomyoblasts via JNK1/2-mediated activation of caspase-3. Further studies are required to investigate whether the identified novel protein targets of PSP play a role in the cytotoxicity of this OP, which is usually associated with the development of OP-induced delayed neuropathy

The Grizzly, September 26, 1980

Equipment Stolen From New Ritter Center • Conversion Eases Skyrocketing Utility Costs • Dean\u27s Office Discloses Frat GPAs • New Windows for NMD • New Spanish Lecturers Interviewed • IF, USGA to Sponsor Fall Picnic • Anderson Addresses College Crowd At Phila. Rally • College Invaded By World Of Technology • Draft Registration Closely Examined • Campus Grounds Receive Face Lift • Hamilton Presents Astronomy Discoveries • Try-outs for Trial by Jury • Weekends at Ursinus • Harriers Place 2nd At Lafayette Invitational • Grizzly Football Handled By W. Maryland • Sports Profile: Craig Walck • Field Hockey Finishes Week Undefeated • Strong Hitting By Bear V-Ball Outdoes Moravian • Offense Sputters As Bears Lose • Kreiger Powers Heathenshttps://digitalcommons.ursinus.edu/grizzlynews/1041/thumbnail.jp

The Grizzly, October 10, 1980

Alternative Housing Investigated • Unchanged since 1960: Activity Fee Increase Likely • Freshman Class Select Officers • Work Stalled On Campus Beautification • Bermans Give Sculpture To College • Ursinus News In Brief: Student chemistry group honored; Study skills workshop to be repeated; College appoints pol sci lecturer • Off-Campus Houses Rewired • Fast Method Discovered for Wismer • African Politics Subject of Oct. 15 Forum • IF Council, USGA Host Fall Picnic • Inactive Alarm System Questioned • Steranko Plays To Sparse Crowd • The Art of Procrastination • Toga! Toga! Toga! • New Ritter Center Dedicated • How To Get To Philly Without A Car • Guide To Ursinus Vocabulary • Science Fiction Books Discussion Offered • Lantern Needs Help • CLC Reveals Findings From Survey • Homecoming Candidates • Three Intramural Teams Clinch Playoff Spot • Booters Take Two • Hockey\u27s Unbeaten Streak Broken • X-Country Places 2nd At Mansfieldhttps://digitalcommons.ursinus.edu/grizzlynews/1043/thumbnail.jp

Telehealth for patients at high risk of cardiovascular disease: pragmatic randomised controlled trial

Objective: To assess whether non-clinical staff can effectively manage people at high risk of cardiovascular disease using digital health technologies. Design: Pragmatic, multicentre, randomised controlled trial. Setting: 42 general practices in three areas of England. Participants: Between 3 December 2012 and 23 July 2013 we recruited 641 adults aged 40 to 74 years with a 10 year cardiovascular disease risk of 20% or more, no previous cardiovascular event, at least one modifiable risk factor (systolic blood pressure ≥140 mm Hg, body mass index ≥30, current smoker), and access to a telephone, the internet, and email. Participants were individually allocated to intervention (n=325) or control (n=316) groups using automated randomisation stratified by site, minimised by practice and baseline risk score. Interventions: Intervention was the Healthlines service (alongside usual care), comprising regular telephone calls from trained lay health advisors following scripts generated by interactive software. Advisors facilitated self-management by supporting participants to use online resources to reduce risk factors, and sought to optimise drug use, improve treatment adherence, and encourage healthier lifestyles. The control group comprised usual care alone. Main outcome measures: The primary outcome was the proportion of participants responding to treatment, defined as maintaining or reducing their cardiovascular risk after 12 months. Outcomes were collected six and 12 months after randomisation and analysed masked. Participants were not masked. Results: 50% (148/295) of participants in the intervention group responded to treatment compared with 43% (124/291) in the control group (adjusted odds ratio 1.3, 95% confidence interval 1.0 to 1.9; number needed to treat=13); a difference possibly due to chance (P=0.08). The intervention was associated with reductions in blood pressure (difference in mean systolic −2.7 mm Hg (95% confidence interval −4.7 to −0.6 mm Hg), mean diastolic −2.8 (−4.0 to −1.6 mm Hg); weight −1.0 kg (−1.8 to −0.3 kg), and body mass index −0.4 (−0.6 to −0.1) but not cholesterol −0.1 (−0.2 to 0.0), smoking status (adjusted odds ratio 0.4, 0.2 to 1.0), or overall cardiovascular risk as a continuous measure (−0.4, −1.2 to 0.3)). The intervention was associated with improvements in diet, physical activity, drug adherence, and satisfaction with access to care, treatment received, and care coordination. One serious related adverse event occurred, when a participant was admitted to hospital with low blood pressure. Conclusions: This evidence based telehealth approach was associated with small clinical benefits for a minority of people with high cardiovascular risk, and there was no overall improvement in average risk. The Healthlines service was, however, associated with improvements in some risk behaviours, and in perceptions of support and access to care

Transfusion of red cells in hematopoietic stem cell transplantation (TRIST): study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Insight regarding transfusion practices in Hematopoietic Stem cell Transplantation (HSCT) are lacking and the impact of red cell transfusion in this high risk group on outcomes following HSCT are not well appreciated. Red blood cell transfusion can be life-saving, however, liberal use of transfusion in critically ill patients failed to demonstrate significant clinical benefit. A large number of other observational studies have also demonstrated an association between red blood cell transfusions and increased morbidity such as infections and multi organ failure as well as increased mortality. The role of red cell transfusion on the clinical outcomes observed in patients undergoing HSCT remains poorly understood and a prospective randomized study of transfusion is required to gain insight and knowledge on best transfusion practices in this high risk population.</p> <p>Methods</p> <p>This report describes the design and methodological issues of a randomized pilot study evaluating red cell transfusion triggers in the setting of Hematopoietic Stem Cell Transplantation. This study has been funded by a peer review grant from the Canadian Blood Services and is registered on Clinicaltrials.gov NCT01237639.</p> <p>Results</p> <p>In 3 Canadian centres, 100 patients undergoing Hematopoietic Stem Cell Transplantation will be randomized to either a restrictive (target hemoglobin of 70-90 g/L) or liberal (target hemoglobin of 90-110 g/L) red cell transfusion strategy, based daily hemoglobin values up to 100 days post-transplant. The study will stratify participants by centre and type of transplant. The primary goal is to demonstrate study feasibility and we will collect clinical outcomes on 1) Transfusion Requirements, 2) Transplant Related Mortality, 3) Maximum grade of acute Graft versus Host Disease, 4) Veno-occlusive Disease, 5) Serious Infections, 6) Bearman Toxicity Score, 7) Bleeding, 8) Quality of Life, 9) Number of Hospitalizations and 10) Number of Intensive Care Unit (ICU) Admissions.</p> <p>Conclusion</p> <p>Upon completion, this pilot trial will provide preliminary insight into red cell transfusion practice and its influence in hematopoietic stem cell transplant outcomes. The results of this trial will inform the conduct of a larger study.</p