Interpretaciones que amenazan al derecho tributario. Tendencias actuales y análisis crítico

Tras introducir al lector en el inmenso y proceloso mundo de la hermenéutica jurídica, el artículo expone una descripción crítica y actual de ciertas formas de interpretación que se constituyen en verdaderas amenazas para el Derecho Tributario, pues, al dejar desprovisto de todo límite al proceso interpretativo, y por ende, al intérprete de la norma tributaria, vulneran e irrespetan principios y garantías fundamentales propias del Derecho fiscal. La finalidad del estudio presentado es doble: por una lado busca advertir, prevenir y corregir aquellas malas prácticas interpretativas de la norma jurídico tributaria. Y, por el otro, propone un sistema integral conforme al cual debe realizarse la interpretación e integración de la ley tributaria, o al menos tenerse presente para ello

Elusión tributaria y normas antielusivas: su tratamiento en el derecho comparado. Algunas conclusiones al respecto

Luego de ofrecer una visión particular del concepto de elusión tributaria, el artículo analiza el tratamiento que se ha dado en el Derecho Comparado a las medidas/normas antielusivas, agrupando a los ordenamientos estudiados en los dos sistemas jurídicos de mayor trascendencia en la actualidad: El Sistema Jurídico Romanista o Civil Law y el Sistema jurídico Anglosajón o Common Law. El propósito de este estudio y la forma de plantearlo así, además de proporcionar una visión esquemática de la manera en que ciertos Estados han combatido el fenómeno elusivo de impuestos, es obtener algunas conclusiones que permitan evaluar la situación existente en nuestro país y la conveniencia o no de su modificación

Staff costs of hospital-based outpatient care of patients with cystic fibrosis

BACKGROUND: This study identified per patient resource use and staff costs at a cystic fibrosis (CF) outpatient unit from the health care provider's perspective. METHODS: Personnel cost data were prospectively collected for all CF outpatients (n = 126) under routine conditions at the Charité Medical School Berlin in Germany over a six month study period. Patients were grouped according to age, sex and two severity categories. Ordinary least squares regression analysis was performed to determine the impact of various independent variables on personnel costs. RESULTS: The mean staff costs were €142.3 per patient over six months of outpatient service. Services provided by physicians were the biggest contributor to staff costs. Patient age correlated significantly and negatively with mean total costs per patient. CONCLUSIONS: Age of patient is a significant determinant of staff costs for CF outpatient care. For a cost-covering remuneration of outpatient treatment it seems plausible to create separate reimbursement rates for two or three age groups and to consider additional costs due to tasks carried out by physicians without direct patient contact. The relatively low staff costs identified by our study reflect a staffing level not sufficient for specialist CF outpatient care

Experimental evaluation into novel, low cost, modular PEMFC stack

Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0)The Polymer Electrolyte Membrane Fuel Cell (PEMFC), despite being regarded as an ideal replacement to the internal combustion engine, is still not an economically attractive pri-mover due to a number of key challenges that have yet to be fully resolved; some of which include degradation to cell components resulting in inadequate lifetimes, specialised and costly manufacturing processes and poor gravimetric/volumetric energy densities. This paper presents a novel stack concept which removes the conventional bi polar plate (BPP), a component that is responsible for up to 80% of total stack weight and 90+% of stack volume in some designs. The removal of said component not only improves the volumetric and gravimetric energy density of the PEMFC stack but drastically reduces the cost of the stack by removing all costly manufacturing processes associated with PEMFC component machining while the functionality of the traditional BPP is still retained by the unique stack design. The stack architecture is first presented and then the characterisation of the PEMFC is shown over a wide range of operating scenarios. The experimental studies suggest that the performance of the new design is comparable to that of traditional stacks but at significantly less cost price.Final Published versio

Hereditary angioedema (HAE) in children and adolescents : a consensus on therapeutic strategies

Hereditary angioedema due to C1 inhibitor (C1 esterase inhibitor) deficiency (types I and II HAE-C1-INH) is a rare disease that usually presents during childhood or adolescence with intermittent episodes of potentially life-threatening angioedema. Diagnosis as early as possible is important to avoid ineffective therapies and to properly treat swelling attacks. At a consensus meeting in June 2011, pediatricians and dermatologists from Germany, Austria, and Switzerland reviewed the currently available literature, including published international consensus recommendations for HAE therapy across all age groups. Published recommendations cannot be unconditionally adopted for pediatric patients in German-speaking countries given the current approval status of HAE drugs. This article provides an overview and discusses drugs available for HAE therapy, their approval status, and study results obtained in adult and pediatric patients. Recommendations for developing appropriate treatment strategies in the management of HAE in pediatric patients in German-speaking countries are provided.Conclusion Currently, plasma-derived C1 inhibitor concentrate is considered the best available option for the treatment of acute HAE-C1-INH attacks in pediatric patients in German-speaking countries, as well as for short-term and long-term prophylaxis

Omalizumab as alternative to chronic use of oral corticosteroids in severe asthma

Systemic/oral corticosteroids (OCS) have been used for decades in the management of acute asthma exacerbations and chronically in patients with uncontrolled severe asthma. However, while OCS are effective at treating acute exacerbations, there is only empirical evidence regarding the efficacy of OCS at reducing the rate of exacerbations. Evidence, although scarce, is suggestive of high exacerbation rates in severe asthma patients even when receiving maintenance treatment with OCS. In addition, use of OCS is associated with undesirable effects. Despite all this, physicians have continued to use OCS for managing severe asthma and acute exacerbation due to the lack of availability of effective alternatives. Fortunately, in the last decade several biologics have been proven safe and effective for patients with uncontrolled severe asthma. This has led to the Global Initiative for Asthma (GINA) recommending the use of biologics, instead of maintenance OCS, in patients with severe asthma (GINA Step 5). These include one biologic targeting immunoglobulin E (IgE) (omalizumab), and different biologics targeting interleukin-5 (IL-5), the IL-5 receptor (IL-5R) or IL-4 receptor alpha-unit (IL-4R alpha), including mepolizumab (subcutaneous), reslizumab (intravenous), benralizumab (subcutaneous) and dupilumab (subcutaneous). Omalizumab for the treatment of severe allergic asthma reduces exacerbations, irrespective of blood eosinophil levels. Anti-IL-5/IL-5R biologics are indicated in patients with severe eosinophilic asthma and repetitive exacerbations, irrespective of the presence or absence of allergy. Recently, an anti-IL4R alpha biologic has been approved by the FDA for eosinophilic phenotype or oral corticosteroid-dependent asthma. Finally, physicians should consider using biologics as an alternative to chronic OCS therapy