This paper analyses the convergence process of environmental fiscal pressure within the framework of the incipient process of economic globalisation and fiscal harmonisation. On the basis of data obtained from Eurostat for the 1987-2008 period, and taking the first fifteen members of the European Union as a reference, we have applied beta, sigma, and gamma-convergence tools to cross-section data. The results obtained have allowed us to verify the existence of convergence in environmental fiscal pressure, except in Denmark and the Low Countries, whose performance is quite different to the rest of the countries due to their high levels of environmental fiscal pressure.
La sexualidad y la reproducción se han tornado en las últimas décadas campos de disputas entre sectores antagónicos, generando una dinámica regional de avances y regresiones en la agenda de derechos sexuales y reproductivos. Chile no ha sido la excepción, y muchas reformas en estas materias han sido frenadas por la oposición ejercida por los sectores más conservadores, mientras otras simplemente no han llegado siquiera a abrirse a discusión pública. La literatura suele destacar la existencia de dos grandes causas que pueden explicar los obstáculos para el reconocimiento de estos derechos en el país: la influencia que ha tenido la jerarquía católica en el delineamiento de políticas sexuales, y el debilitamiento de los movimientos feministas y de mujeres en el período post-dictatorial. El presente artículo analiza ciertos factores que buscan iluminar las causas de estos dos procesos. En el caso de la Iglesia Católica, se consideran dos factores que explicarían la influencia de esta institución en el delineamiento de las políticas sexuales de la post-dictadura: la autoridad moral conferida a la misma por su rol social y político desempeñado durante el siglo XX, y el rol otorgado por las elites a la iglesia en la búsqueda del consenso político durante los noventa. Para el caso del feminismo, se analizan en tanto los procesos de normalización del discurso, la devaluación de la militancia y la institucionalización del movimiento como factores explicativos de su debilitamiento en la capacidad para incidir en las políticas sexuales.
Background: The role of combination immunomodulatory therapy with systemic corticosteroids and tocilizumab (TCZ) for aged patients with COVID19 associated cytokine release syndrome remains unclear.
Methods: We conducted a retrospective single center study including consecutive patients older than 65 years that developed severe COVID19 between March 3 and May 1, 2020 and were treated with corticosteroids at various doses (methylprednisolone [0.5 mg/Kg/12 hours to 250 mg/24 hours]), either alone (CS group) or associated to intravenous tocilizumab (400 to 600 mg, one to three doses) (CS/TCZ group). Primary outcome was all cause mortality by day +14, whereas secondary outcomes included mortality by day +28 and clinical improvement (discharge and/or a 2 point decrease on a six point ordinal scale) by day +14. Propensity score (PS)based adjustment and inverse probability of treatment weights (IPTW) were applied.
Results: Overall, 181 and 80 patients were included in the CS and CS TCZ groups. All cause 14 day mortality was lower in the CS/TCZ group, both in the PS adjusted (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.17 to 0.68; P value = 0.002) and IPTW weighted models (odds ratio [OR]: 0.38; 95% CI: 0.21 to 0.68; P value = 0.001). This protective effect was also observed for 28 day mortality (PS adjusted HR: 0.38; 95% CI: 0.21 to 0.72; P value = 0.003). Clinical improvement by day +14 was higher in the CS/TCZ group in the IPTW analysis only (OR: 2.26; 95% CI: 1.49 to 3.41; P value <0.001). The occurrence of secondary infection was similar between both groups.
Conclusions: The combination of corticosteroids and TCZ was associated with better outcomes among patients older than 65 years with severe COVID-19.
The contact interaction between elastic solids is one of the most complex phenomena in the computational mechanics research field. The solution of such problem requires robust algorithms to treat the geometrical non-linearities characteristic of the contact constrains. The Finite Element Method (FE) has become one of the most popular options for the mechanical components design, including the solution of contact problems. In this method the computational cost of the generation of the discretization (mesh generation) is directly related to the complexity of the analysis domain, namely its boundary. This complicates the introduction in the numerical simulations of complex surfaces (for example NURBS), which are being increasingly used in the CAD industry. This thesis is grounded on the Cartesian grid Finite Element Method (cgFEM). In this methodology, which belongs to the family of Immersed Boundary methods, the problem at hand is extended to an approximation domain which completely embeds the analysis domain, and its meshing is straightforward. The decoupling of the boundary definition and the discretization mesh results in a great reduction of the mesh generation's computational cost. Is for this reason that the cgFEM is a suitable tool for the solution of problems that require multiple geometry modifications, such as shape optimization problems or wear simulations. The cgFEM is also capable of automatically generating FE models from medical images without the intermediate step of generating CAD entities. The introduction of the contact interaction would open the possibility to consider different states of the union between implant and living tissue for the design of optimized implants, even in a patient-specific process. Hence, in this thesis a formulation for solving 3D contact problems with the cgFEM is presented, considering both frictionless and Coulomb's friction problems. The absence of nodes along the boundary in cgFEM prevents the enforcement of the contact constrains using the standard procedures. Thus, we develop a stabilized formulation that makes use of a recovered stress field, which ensures the stability of the method.
Resumen: El artículo analiza críticamente la forma en la que se planteado el debate ético y jurídico en torno al aborto, como un conflicto de derechos entre el embrión y la mujer, mostrando los modos en los que se ha construido la figura del embrión, como un sujeto susceptible de valoración moral y protección jurídica. En particular, se discute la posición que asume al cigoto indefectiblemente como un sujeto moral, por el hecho de poseer un genoma distinto del de sus progenitores, otorgándole un estatuto jurídico equivalente al de las mujeres. Así, se establece una crítica en torno al modo como esta posición, a través del uso de un lenguaje científico que se presenta como objetivo, ha tendido a invisibilizar las formas sociales y culturales que construyen la valoración de la vida.
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