Characterization of Maternal Mortality and Severe Maternal Morbidity before and during Covid-19: an analysis for the Dominican Republic (preprint)

The Covid-19 pandemic disturbed the delivery of health services, which included obstetric care, in many parts of the word. In countries where maternal mortality was already elevated before the pandemic, this disruption brought about catastrophic events. Using data from the Sistema Nacional de Vigilancia Epidemiológica (SINAVE) of the maternal morbidity and mortality of the Dominican Republic, this paper estimated the severe maternal morbidity rate and the maternal mortality rate by causes of death (direct, indirect, and specific causes). Mixed effects models were used to identify individual and contextual factors that contribute to a higher risk of dying. Results indicate that the severe maternal morbidity rate decrease from 12.1 to 10.4 per 1,000 live births in 2020 compared to 2019; however, the maternal mortality rate went from 91.4 to 124.2 per 100,000 live births in the same period. In 2021, a significant increase in morbidity and mortality was observed, registering a rate of 16.5 cases of severe maternal morbidity per 1,000 live births and a rate of 153.7 maternal deaths per 100,000 live births. Additionally, maternal mortality in the Dominican Republic is associated with the sociodemographic and economic conditions of women, revealing inequalities related to national origin, area of residence and access to health services which were worsening during the pandemic.

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon (preprint)

Background: Globally, healthcare institutions have seen a marked rise in workplace violence (WPV), especially since the Covid-19 pandemic began, affecting primarily acute care and emergency departments (EDs). At the University Health Network (UHN) in Toronto, Canada, WPV incidents in EDs jumped 169% from 0.43 to 1.15 events per 1000 visits (p<.0001). In response, UHN initiated a comprehensive quality improvement (QI) project to address WPV. This study presents the project's design, implementation, results, and key takeaways, aiming to showcase effective and trauma-informed strategies for mitigating WPV in healthcare settings. Methods: Our multi-intervention QI initiative was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework. We also leveraged the SEIPS 101 tools to aid in crafting each QI intervention. This approach amalgamated various methodologies to approach WPV, incorporating literature reviews, a modified Delphi method, qualitative interviews, surveys, quantitative data gathering and pragmatic interventions. Results: Our complex intervention contained a total of 12 subprojects. We reviewed existing literature (n=84) pertaining to WPV in healthcare. N = 229 quality indicators utilized to measure WPV in healthcare were extracted from the literature and underwent a Delphi process which yielded 17 quality indicators for a new organizational WPV dashboard. WPV theories were critically reviewed in the context of intervention development. Educational initiatives (n=2) were implemented including ad-hoc point of care training, as well as rollout of a comprehensive trauma-informed training program for WPV prevention, verbal de-escalation and management of escalated responsive behaviour. Further changes involved establishing a Code White Governance Committee, enhancing WPV reporting and addressing underreporting. Debriefing was structured into hot and cold debriefing models. Additionally, environmental indicators promoting mutual respect were introduced, alongside security enhancements including wearable video devices for all security guards and a 100% increase in ED security guards. Outreach initiatives were implemented including qualitative interviews with ED staff (n=75) and the development of a patient partner and community outreach group. Conclusions: WPV in healthcare is a complex phenomenon that urgently requires effective solutions. We developed a 13-step framework that offers guidance for healthcare institutions seeking to develop a systemic approach in addressing WPV tailored to their organization’s needs.

Violencia de la pareja íntima a la mujer: daño psicológico durante la pandemia COVID-19 (preprint)

Durante el COVID-19 hubo un incremento de la violencia de la pareja íntima (VPI) hacia las mujeres. En la República Dominicana se realizó un estudio, durante la pandemia, para evaluar el daño psicológico en las mujeres VPI y determinar la relación entre los tipos de violencia experimentados y la sintomatología de ansiedad, depresión, trastorno de estrés postraumático (TEPT) y autoestima. Metodología: El estudio fue transversal, descriptivo y correlacional con una muestra de 96 mujeres que buscaron ayuda psicológica. Resultados: La edad media fue 33.6. Hubo una correlación entre la violencia sexual y ansiedad, así como entre la violencia económico-patrimonial con la violencia física y la violencia sexual. La gran mayoría de los síntomas correlacionaron entre sí, excepto la reexperimentación con autoestima. Conclusión: La salud mental de las mujeres víctimas VPI se ve comprometida debido a la comorbilidad de los síntomas presentados.

Regional epidemic dynamics and Delta variant diversity resulted in varying rates of spread of Omicron-BA.1 in Mexico (preprint)

The Omicron subvariant BA.1 of SARS-CoV-2 was first detected in November 2021 and quickly spread worldwide, displacing the Delta variant. In Mexico, this subvariant began spreading during the first week of December 2021 and became dominant in the next three weeks, causing the fourth COVID-19 epidemiological surge in the country. Unlike previous SARS-CoV-2 variants, BA.1 did not acquire local substitutions nor exhibited a geographically distinct circulation pattern in Mexico. However, a regional difference in the speed of the replacement of the Delta variant was observed, as some northern states showed persistence of Delta lineages well into February 2022. Mexican states were divided into four regions (North, Central North, Central South, and Southeast) based on the lineage circulation before the dominance of BA.1 to study possible causes for this difference. For each region, the time to fixation of BA.1, the diversity of Delta sublineages in the weeks preceding BA.1 entry, the population density, and the level of virus circulation during the inter-wave interval were determined. An association between a faster Omicron spread and lower Delta diversity, as well as fewer COVID-19 cases during the Delta-BA.1.x inter-wave period, was observed. For example, the North region exhibited the slowest spread but had the highest diversity of Delta sublineages and the greatest number of inter-wave cases relative to the maximum amount of the virus circulating in the region, whereas the Southeast region showed the opposite. Viral diversity and the relative abundance of the virus in a particular area around the time of the introduction of a new lineage seem to have influenced the spread dynamics. Nonetheless, if there is a significant difference in the fitness of the variants or the time allowed for the competition is sufficient, it seems the fitter virus will eventually become dominant, as observed in the eventual dominance of the BA.1.x variant in Mexico. Impact statementThe surveillance of lineage circulation of SARS-CoV-2 has helped identify variants that have a transmission advantage and are of concern to public health and to track the virus dispersion accurately. However, many factors contributing to differences in lineage spread dynamics beyond the acquisition of specific mutations remain poorly understood. In this work, a description of BA.1 entry and dispersion within Mexico is presented, and which factors potentially affected the spread rates of the Omicron variant BA.1 among geographical regions in the country are analyzed, underlining the importance of population density, the proportion of active cases, and viral lineage diversity and identity before the entry of BA.1. Data summaryThis work was carried out using data shared through the GISAID initiative. All sequences and metadate are available through GISAID with the accession EPI_SET_220927gw, accession numbers and metadata are also reported in the supplemental material of this article. Epidemiological data was obtained though the Secretaria de Salud website (https://www.gob.mx/salud/documentos/datos-abiertos-152127),

Comparative diagnostic performance of the new chromatographic Affimer(R)-based rapid antigen detection against SARS-CoV-2 and other standard antigen tests for COVID-19 in a clinical setting. (preprint)

The availability of accurate and rapid diagnostic tools for COVID-19 is essential for tackling the ongoing pandemic. In this context, researchers in the UK have started testing a new Lateral Flow Device (LFD) based on proprietary Biotinylated anti SARS-CoV-2 S1 Affimer(R) technology that binds to the SARS-CoV2-S1 protein in anterior nasal swab samples, generating an ultra-sensitive method for detection. This international study aimed to compare its performance against other available antigen-detecting rapid diagnostic tests (Ag-RDTs) in a real-world clinical setting. The study was completed under the frame of Project SENSORNAS RTC-20176501 in collaboration with MiRNAX Biosens Ltd. and Hospital Carlos III, it was documented internally and deposited in agreement to the ISO 13485 norm. All the data obtained are currently under submission and review from the Ethics Committee of Universidad Autonoma de Madrid.

Ortalama-Varyans Modeli ile Portföy Optimizasyonu: COVID-19 Pandemisinin ABD ve ÇİN Üzerindeki Etkilerinin Kıyaslanması (Portfolio Optimization with the Mean-Variance Model: Comparing the Impacts of the COVID-19 Pandemic on the USA and China) (preprint)

Turkish Abstract: Portföy yöneticileri riskini minimize ederken, getirisinin de maksimum olmasını ister. Fakat çok sayda menkul kıymet arasından hangi varlıkların seçilmesi ve her birine hangi ağırlığın verilmesi çok zorlu bir süreçtir. Riskini minimum ve o risk düzeyine uygun getirisini de maksimum yaparken, bu getiri/risk özelliklerine uygun varlıkların seçilmesi, optimal portföy yaratmada önemli konulardır. Geleneksel teoride optimal portföy için riski minimum etmek ve bunun için de çeşitlendirme yapmanın yeterli olduğu savunulurdu. Markowitz’in literatüre kazandırdığı Ortalama Varyans modeli, modern portföy teorisinin temel taşlarını koydu. Markowitz’e göre menkul kıymetlerin getirileri arasındaki ilişkinin de riski azaltma üzerinde etkisi vardır. Bunun için varlıklar arasındaki korelasyonu dikkate almak gerekir. Pozitif ilişki içinde bulunan varlıkların aynı portföye dahil edilmesi riski artıracaktır. Pandemi, savaş ve bu gibi olayların portföy çeşitlendirmesindeki etkilerini göz önünde bulundurarak, bu etkilerin farklı ülkelere farklı etkiler ettiğini de göz ardı etmemek gerekir. Bu makalede, COVID-19 pandemisinin portföy seçimindeki etkileri gelişmiş (ABD) ve gelişmekte olan (ÇİN) 2 ülke arasındaki etkileri bakımından araştırılmıştır. Portföyde olan varlık sayının her iki ülkede de pandemi döneminde pandemi öncesine kıyasla arttırıldığı kanıtlanmıştır. Pandemi döneminde iki ülkede hangi hisse senetlerine ve hangi sektöre ağırlık verildiği bulunmuştur.English Abstract: Portfolio managers minimize their risk, and want maximum returns. But it's a very difficult process to choose which assets are among the many assets and each one is weighed. Choosing assets that meet these return/risk characteristics is key to creating optimal portfolio while maximizing the risk and return to that risk level. The traditional theory argued that it was sufficient to minimize risk for optimal portfolio and to diversify it. Markowitz's Mean Variance, which earned literature, laid out the cornerstones of modern portfolio theory. According to Markowitz, the relationship between the benefits of securities also has an impact on mitigating risk. To do this, it is necessary to consider the correlation between the assets. The inclusion of assets in a positive relationship into the same portfolio will increase the risk.Considering the effects of pandemic, war and such events on portfolio diversification, it should not be ignored that these effects affect different countries. In this article, the impact of COVID-19 pandemic on portfolio selection has been studied in terms of the effects between the developed (USA) and the 2 developing (CHINA) countries. The number of assets in the portfolio has been proven to be increased in both countries in the pandemic period compared to before pandemic. During the pandemic period, the two countries found which stocks and which sectors were weighed.

Social Inequalities Negatively Impact SARS-CoV-2 Seroprevalence in Different Subgroups of Healthcare Workers in Rio De Janeiro (preprint)

Background: COVID-19 has exacerbated health inequalities worldwide. Yet, such a perspective has not been investigated in specific healthcare workers and their resulting inclusion as a priority group for vaccination have been an important focus of political and social discussion. This study aimed at investigating whether SARS-CoV-2-seropositivity in healthcare workers in a public hospital in Rio de Janeiro, Brazil, was influenced by social determinants of health and the social vulnerability in subgroups of workers. Methods: A serological survey was conducted in 1,154 healthcare workers in June and July 2020. The association between the serological test results for detection of IgG antibodies to SARS-CoV-2 and socioeconomic, occupational characteristics and transportation used by the workers to commute was assessed using the Pearson´s chi-square test and Carmer’s V. Findings: Overall, the serum prevalence for the virus in the healthcare workers was 30%. Non-white workers with lower income and schooling, as well as users of the mass transportation system showed the highest infection rates. Importantly they mostly corresponded to hospital support workers, in particular the cleaning personnel. Accordingly, income, schooling and work modality appeared as negative predictors, as ascertained by forest plot analysis. Interpretations: The data clearly illustrate the inequality in SARS-CoV-2 infection in the Brazilian population, comprising even healthcare workers of the Brazilian unified health system.Funding Information: This study was financed by Fiocruz, CNPq, Faperj, Capes, FOCEM/Mercosur and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.Declaration of Interests: The authors declare no competing financial interests.Ethics Approval Statement: “Clinical and immunological characteristics of children, adolescents, and adults with COVID-19 diagnosis: COVID-19 Kids Project” was submitted to the Institutional Review Board of IFF (CEP/IFF) under identification number 30487120.2.0000.0008 and approved under review number 4.100.148. There was no discrimination in the selection of research subjects or exposure to unnecessary risks.

Do Monetary Policy Measures Affect Foreign Exchange Rates during the COVID-19 Pandemic? Evidence from Turkey (preprint)

English Abstract: The study examines how foreign exchange (FX) rates in Turkey are affected by the pandemic considering the impacts of monetary policy responses to the pandemic. Selected FX rates are examined by using 10 independent variables containing monetary policy indicators and the pandemic figures. In this context, daily data from February 1, 2019 to August 31, 2020 that consists of the pre-pandemic and the pandemic periods are considered and machine learning algorithms are applied. The findings reveal that the pandemic and monetary policy indicators have a statistically significant and high effect on the FX rates, and the influence of independent factors on the FX rates vary according to the periods. According to the results of the study, it is emphasized the importance of the pandemic and monetary policy measures on the FX rates because monetary policy indicators have a statistically significant and high impact on the FX rates in Turkey for the pandemic period.Turkish Abstract: Çalışma, pandemiye yönelik para politikası tedbirlerini dikkate alarak Türkiye’de döviz kurlarının pandemiden nasıl etkilendiğini incelemektedir. Seçilmiş döviz kurları, para politikası göstergeleri ve pandemi rakamlarını içeren 10 bağımsız değişken kullanılarak incelenmiştir. Bu kapsamda, pandemi öncesi ve pandemi dönemlerinden oluşan 1 Şubat 2019 ve 31 Ağustos 2020 arasındaki günlük veriler dikkate alınmış ve makine öğrenmesi algoritmaları uygulanmıştır. Bulgular, pandemi ve para politikası tedbirlerinin döviz kurları üzerinde istatistiksel olarak anlamlı ve yüksek bir etkiye sahip olduğunu ve bağımsız değişkenlerin döviz kurları üzerindeki etkisinin dönemlere göre farklılık gösterdiğini ortaya koymaktadır. Çalışmanın sonuçlarına göre, para politikası tedbirlerinin pandemi döneminde için Türkiye’deki döviz kurları üzerinde istatistiksel olarak anlamlı ve yüksek bir etkiye sahip olması nedeniyle, pandemi ve para politikası tedbirlerinin döviz kurları üzerindeki önemi vurgulanmaktadır.

La désinformation au Brésil sous le gouvernement de Jair Bolsonaro durant la pandémie de Covid-19 (Disinformation in Brazil under the Jair Bolsonaro Government in Times of COVID-19 Pandemic) (preprint)

Par Eddy Célestin, étudiant finissant à la Licence en Sciences Sociales (Universidade Federal da Fronteira Sul / UFFS, au Brésil) sous la supervision Patrick White, professeur de journalisme, École des médias, Université du Québec à Montréal (UQAM), dans le cadre du stage de recherche Mitacs GlobalinkDepuis l’arrivée de Jair Messias Bolsonaro comme président du Brésil et même avant cela, c’est-à-dire durant la période des élections de 2018; la désinformation est devenue de plus en plus présente au pays. Cette désinformation s'effectue principalement sur les réseaux sociaux, certains auteurs parlent même d’une épidémie de fausses nouvelles qui se serait emparée du Brésil. Et avec le développement de la pandémie de Covid-19, la situation est devenue plus préoccupante. Le président Bolsonaro, connu pour son autoritarisme, ses attaques racistes, sexistes et ses fausses accusations de corruption; utilise les mêmes techniques pour décrédibiliser l’approche scientifique dans le combat contre la Covid-19. L’objectif de cette recherche consiste en l’analyse et la compréhension du mécanisme derrière ce processus de désinformation, au Brésil, en temps de Covid-19 sur les réseaux sociaux et les applications de messagerie instantanée comme WhatsApp.Mots-clés: Désinformation. Brésil. Covid-19. Jair Bolsonaro. Réseaux sociaux, Fake NewsAbstractSince the arrival of Jair Messias Bolsonaro as president of Brazil and even before that, that is to say during the period of the elections of 2018; disinformation has become increasingly prevalent in the country. This disinformation is carried out mainly on social networks, some authors even speak of an epidemic of Fake News which has taken hold of Brazil. And with the development of the pandemic linked to Covid-19, the situation has become more worrying. President Bolsonaro, known for his authoritarianism, his racist and sexist attacks and his false accusations of corruption; continues to proceed by the same techniques to discredit the scientific approach in the fight against Covid-19. The objective of this research is to analyze and understand the mechanism behind this process of disinformation, in Brazil, in times of Covid-19 on social networks and instant messaging applications such as WhatsApp.

Actitud hacia la vacuna contra el COVID-19 en Honduras: el rol de la preocupación por el virus y el sentido de pertenencia comunitaria (preprint)

El presente estudio tuvo como propósito analizar la actitud hacia la vacunación contra el COVID-19, en relación con la preocupación por el virus, el sentido de pertenencia comunitaria, y variables demográficas. Esto por medio de un enfoque cuantitativo, en una muestra de 478 hondureños. Los datos fueron recolectados por medio de cuestionarios de autoreporte. En la aplicación se incluyó la Escala de Preocupación por el COVID-19 (CAS-6), la Breve Escala de Sentido de Pertenencia Comunitaria (BESPC), así como preguntas respecto a la aceptación de la vacuna contra el COVID-19. Los resultados indican que el 8.368% de los participantes no han recibido la vacuna contra el COVID-19, 44.979% han recibido una dosis y el 46.653% han recibido dos dosis de la vacuna. La mayor parte de los encuestados (86.820%) tienen una alta aceptación hacia la vacuna contra el COVID-19, únicamente 13.180% de los participantes reportaban bajos niveles de aceptación. Una mayor aceptación de la vacuna está asociada a la cantidad de dosis recibidas. Se realizó un análisis de regresión logística, por pasos, para determinar las variables que inciden significativamente sobre la actitud hacia la vacunación. Las variables independientes incluidas fueron: edad, sexo, diagnóstico previo de COVID-19, CAS-6 Preocupación Personal, CAS-6 Gravedad Percibida y Sentido de Pertenencia Comunitaria. Los resultados indican que la Gravedad Percibida del COVID-19 y la edad del informante son predictores positivos estadísticamente significativos de la aceptación hacia la vacunación por el COVID-19. El resto de las variables independientes hipotéticas resultaron no significativas.

The Brexit Hammer: Repercussions for the US and Transatlantic Relations in Times of Corona (preprint)

English Abstract: The global revival of economic nationalism and protectionism poses a serious threat to the international foreign trade policy orientation towards principles of a market economy. Popular economic nationalism such as Trumpism, Brexit or the isolation of the Eastern European Visegrád states from immigrants violates fundamental principles of the WTO. Economists agree that Brexit will hurt the UK economy significantly in the medium and long term. In addition, its political and economic effects will damage the US and transatlantic relations. British Prime Minister Boris Johnson, on the other hand, continues to claim that leaving the EU will enable Britain to "take back control". In addition, the socioeconomic effects of the Corona crisis on the US, UK, EU and transatlantic relations are devastating. It has far-reaching political, social and economic consequences that go well beyond public health. All partners need each other more than ever to cope with the Covid crisis. Increased transatlantic cooperation to strengthen resilience would also be necessary in closely related areas of international relations and security issues.French Abstract:Le renouveau mondial du nationalisme économique et du protectionnisme constitue une menace sérieuse pour l'orientation de la politique internationale du commerce extérieur vers les principes de l'économie de marché de l'OMC. Les économistes s'accordent à dire que le Brexit nuira considérablement à l'économie britannique à moyen et long terme. En outre, ses effets politiques et économiques endommageront également les États-Unis et les relations transatlantiques. Le Premier ministre britannique Boris Johnson, quant à lui, continue d'affirmer que la sortie de l'UE permettra à la Grande-Bretagne de « reprendre le contrôle ». De plus, les effets socio-économiques de la COVID-19 pandémie sur les États-Unis, la Grande-Bretagne, l'UE et les relations transatlantiques sont dévastateurs. Elle a des conséquences politiques, sociales et économiques de grande envergure qui vont bien au-delà de la santé publique. Tous les partenaires ont plus que jamais besoin les uns des autres pour faire face à la crise du Covid. Une plus grande coopération transatlantique pour renforcer la résilience serait également nécessaire dans des domaines étroitement liés des relations internationales et des questions de sécurité.German Abstract:Die weltweite Wiederbelebung des wirtschaftlichen Nationalismus und des Protektionismus stellt eine ernsthafte Bedrohung für die international außenwirtschaftspolitische Orientierung an den Prinzipien der Marktwirtschaft dar. Populärer Wirtschaftsnationalismus wie Trumpismus, Brexit oder die Abschottung der osteuropäischen Visegrád-Staaten gegen Einwanderer verstößt gegen grundlegende Prinzipien der WTO. Die Ökonomen sind sich einig, dass der Brexit der britischen Wirtschaft mittel und langfristig erheblich schaden wird. Darüber hinaus werden seine politischen und wirtschaftlichen Auswirkungen auch den USA und den transatlantischen Beziehungen schaden. Der britische Premier Boris Johnson behauptet dagegen nach wie vor, dass der Austritt aus der EU Großbritannien in die Lage versetzen wird, „die Kontrolle zurückzugewinnen“. Außerdem sind die sozioökonomischen Auswirkungen der Corona-Krise auf die USA, Großbritannien, die EU und die transatlantischen Beziehungen verheerend. Sie hat weitreichende politische, soziale und wirtschaftliche Folgen, die weit über die öffentliche Gesundheit hinausgehen. Alle Partner brauchen einander mehr denn je, um die Covid-Krise zu bewältigen. Auch in eng verwandten Bereichen der internationalen Beziehungen und Sicherheitsfragen wäre eine verstärkte transatlantische Zusammenarbeit zur Stärkung der Resilienz erforderlich.

Inteligencia Artificial, Compliance y Derecho del Consumo Estructuras de gobernanza empresarial y estatal frente al empleo de algoritmos durante la pandemia y más allá. (Artificial Intelligence, Compliance and Consumer Law. Corporate and State Governance Structures Facing the Use of Algorithms during the Pandemic and Beyond) (preprint)

Spanish Abstract: El empleo masivo de datos y decisiones algorítmicas en los procesos de producción y comercialización de bienes y servicios y, en su extremo, el uso de Inteligencia Artificial (IA), es una tendencia creciente cuya velocidad se ha disparado durante la crisis sanitaria de la Covid 19 en 2020. Estructuralmente, más allá de la aceleración de coyuntura, no es previsible que esa tendencia revierta a niveles precedentes. El grado de integración de esas tecnologías a los procesos destinados al consumo es tal que, regular cada uno de sus aspectos contingentes (machine learning, IA, etc.) por separado, puede ser insuficiente y hasta atentar contra el éxito de los propósitos del Derecho de Consumo. La introducción de la electricidad en el mercado puede servir de analogía: en un momento fue una innovación particularmente útil y peligrosa pero no parecería, hoy, razonable, a los fines del Derecho del Consumo, distinguir procesos de producción y comercialización que la emplean y otros que no; exigir la presencia de un funcionario responsable de la electricidad dentro de la empresa para el caso de utilizarla o una agencia estatal de supervisión de productores profesionales que la utilizan. Al contrario, parece más adecuado regular los sistemas de producción y comercialización asumiendo que estarán consustancialmente impregnados y determinados por aquellas tecnologías: tanto la ya antigua electricidad, cuando la novedosa IA. El nivel de complejidad que tales tecnologías introducen en aquellos procesos determina que la estrategia de compliance de Derecho del Consumo, conjuntamente con instrumentos jurídicos tradicionales, heterónomos (sanciones penales y administrativas, responsabilidad civil), sea preferible por sobre el desempeño de esos últimos sin combinación con la primera. Las conclusiones de la Economía de los Costos de Transacción y consideraciones conductuales que se apartan del modelo económico Neoclásico abonan la preferibilidad de esta posibilidad. La empresa no es una estructura trasmisora transparente de los incentivos impuestos por los costos privados derivados de las sanciones heterónomas, hacia los individuos que la componen. Esa transmisión es imperfecta y asincrónica, lo cual puede incrementar significativamente los costos sociales. El momento en que se dé el monitoreo de las decisiones empresarias y la posibilidad de influir en esa esfera, los mecanismos de circulación interna de la información y las modalidades de aplicación de normas de alta indeterminación resultan factores relevantes, respecto de los cuales las estrategias puramente heterónomas más tradicionales pueden lidiar solo deficientemente.English Abstract: The massive use of data and algorithmic decisions in processes of production and marketing of goods and services and, ultimately, the use of Artificial Intelligence (AI), is a growing trend whose speed has skyrocketed during the COVID-19 health crisis in 2020. Beyond the pandemic, the reversion of this trend is not predictable. The degree of integration of these technologies into processes aiming to consumption is such that regulating each of their contingent aspects (machine learning, AI, etc.) may be inappropriate and even, may jeopardize the success of the purposes of consumer law. The introduction of electricity in the market can serve as an analogy: at one time it was a particularly useful and dangerous innovation. However, nowadays it would not seem reasonable, for the purposes of Consumer Law, to distinguish production and marketing that use electricity and others that do not; to require the presence of an official responsible for electricity within the company or a specific consumer agency supervising firms who use electric power in their operation. On the contrary, it seems more appropriate to design the Consumer Law assuming that production and marketing will be inherently impregnated by those technologies: both the old electricity and the new AI. The level of complexity that new data technologies introduce in those processes determines that internal compliance strategies, together with traditional, heteronomous legal instruments (criminal and administrative sanctions, civil liability), is preferable over the performance of the latter without the former. The conclusions of Transaction Cost Economics and behavioral considerations that depart from Neoclassical economic basis support the preferability of this possibility. The firm is not a transparent transmitter of the incentives derived from public sanctions to its officers and employees. This transmission is imperfect and asynchronous, which can significantly increase social costs. The timing of monitoring corporate decisions and the possibility of influencing this sphere, the internal circuits of information and the particulars of application of highly indeterminate rules are relevant factors with respect to which the more traditional heteronomous strategies can cope only poorly.

L'impact socio-économique du Brexit sur l'Inde, le Pakistan et le Sri Lanka au temps de Corona (The Socio-Economic Impact of Brexit on India, Pakistan and Sri Lanka in Times of Corona) (preprint)

The English version of this paper can be found at http://ssrn.com/abstract=3888450French Abstract: À la suite du Brexit, Londres a approuvé une union CANZUK avec ses anciennes colonies de colons blancs, le Canada, l'Australie et la Nouvelle-Zélande. Cela se voulait une alternative valable à la perte d'accès au marché de l'UE. En revanche, les anciens dominions britanniques non blancs – qu'ils soient grands (comme l'Inde et le Pakistan) ou petits (comme le Sri Lanka) ont été laissés à eux-mêmes. Le gouvernement indien a d'abord perçu le vote sur le Brexit comme plutôt malheureux car il augmenterait l'instabilité mondiale et un affaiblissement de l'Occident. Cependant, des multinationales indiennes comme « Tata », qui avaient massivement investi en Grande-Bretagne comme porte d'entrée vers l'Europe, ont vu dans le Brexit un risque économique. Plus tard, New Delhi a également réalisé des avantages politiques éventuels en Grande-Bretagne quittant l'UE. L'impact du Brexit sur l'économie pakistanaise est resté faible jusqu'à présent. Cependant, Islamabad serait bien avisé de formuler des politiques distinctes pour la Grande-Bretagne post Brexit et le reste de l'UE-27. Les liens économiques et politiques du Sri Lanka avec le Royaume-Uni, en revanche, sont considérablement plus forts qu'avec n'importe quel pays de l'UE. Le commerce annuel avec le Royaume-Uni s'élevait à plus de 10 %. Par conséquent, le Brexit a eu un impact négatif sur l'économie Sri Lankaise. Des changements visant à renforcer les relations économiques avec le Royaume-Uni pour surmonter les défis post-Brexit étaient impératifs. Quant à la pandémie de COVID-19, elle est rapidement devenue dans les trois pays non seulement une urgence sanitaire mais aussi une crise sociale et économique. Compte tenu de la responsabilité historique du Royaume-Uni en tant qu'ancienne puissance coloniale et de l'engagement renouvelé de Londres envers les principes du libre-échange international, il semble pour le moins discutable si le gouvernement britannique ne devrait pas considérer toutes ses anciennes colonies comme des partenaires égaux concernant sa politique de commerce extérieur et accorder les mêmes droits et facilités.English Abstract: Following the Brexit, London endorsed a CANZUK union with its former white settler colonies, Canada, Australia and New Zealand. This was meant as a valuable alternative to replace lost EU-market access. In contrast, non-white former British dominions – whether big (like India, Pakistan) or small (like Sri Lanka) were left on their own. The Indian Government perceived the Brexit vote initially as rather unfortunate because it would increase global instability and a weakening of the West. Indian multinationals like 'Tata', however, which had invested heavily in Britain as their gateway to Europe, saw Brexit as an economic risk. Later on, New Delhi realised also eventual policy advantages in Britain leaving the EU. The Brexit impact on Pakistan’s economy remained small so far. However, Islamabad would be well advised to formulate separate policies for post-Brexit Britain and the remaining EU-27. Sri Lanka's economic and political ties with the UK, on the other hand, are considerably stronger than with any EU country. Annual trade with the UK amounted to over 10 %. Therefore, Brexit impacted negatively on the Sri Lankan economy. Changes to strengthen economic relations with the UK to overcome post Brexit challenges were imperative. As for the COVID-19 pandemic, it soon became in all three countries not just a health emergency but also a social and economic crisis. Given the historic responsibility of the UK as a former colonial power and the renewed commitment of London to international free trade principles, it seems at least debatable whether the British government should not consider all its former colonies as equal partners concerning its foreign trade policy and grant them the same rights and facilities.German Abstract: Neben dem Brexit befürwortet London eine CANZUK-Partnerschaft mit seinen ehemaligen weißen Siedlerkolonien Kanada, Australien und Neuseeland. Dies sah London als wertvolle Alternative zum verlorenen EU-Marktzugang. Im Gegensatz dazu wurden nicht-weiße ehemalige britische Herrschaftsgebiete – ob groß (wie Indien und Pakistan) oder klein (wie Sri Lanka) – sich selbst überlassen. Die indische Regierung empfand das Brexit-Votum zunächst als eher unglücklich, weil es die globale Instabilität und eine Schwächung des Westens erhöhen würde. Indische multinationale Konzerne wie „Tata“, die stark in Großbritannien als Tor nach Europa investiert hatten, sahen den Brexit jedoch als wirtschaftliches Risiko. Später erkannte Neu-Delhi auch eventuelle politische Vorteile beim Austritt Großbritanniens aus der EU. Die Auswirkungen des Brexit auf die pakistanische Wirtschaft blieben bisher gering. Islamabad wäre jedoch gut beraten, eine separate Politik für Großbritannien und die verbleibenden EU-27 nach dem Brexit zu formulieren. Die wirtschaftlichen und politischen Beziehungen Sri Lankas zum Vereinigten Königreich sind dagegen deutlich stärker als zu jedem anderen EU-Land. Der jährliche Außenandel mit Großbritannien betrug über 10 %. Daher wirkte sich der Brexit negativ auf die srilankische Wirtschaft aus. Veränderungen zur Stärkung der Wirtschaftsbeziehungen mit dem Vereinigten Königreich zur Bewältigung der Herausforderungen nach dem Brexit waren zwingend erforderlich. Die COVID-19-Pandemie entwickelte sich in allen drei Ländern schnell von einem Gesundheitsnotstand zu einer sozialen und wirtschaftlichen Krise. Angesichts der historischen Verantwortung Großbritanniens als ehemaliger Kolonialmacht und des erneuten Bekenntnisses Londons zu internationalen Freihandelsprinzipien erscheint es zumindest fraglich, ob die britische Regierung nicht alle ihre ehemaligen Kolonien als gleichberechtigte Partner in ihrer Außenhandelspolitik betrachten und ihnen gleiche Rechte und Möglichkeiten einräumen sollte.

The Socio-Economic Impact of Brexit on India, Pakistan and Sri Lanka in Times of Corona (preprint)

English Abstract: Following the Brexit, London endorsed a CANZUK union with its former white settler colonies, Canada, Australia and New Zealand. This was meant as a valuable alternative to replace lost EU-market access. In contrast, non-white former British dominions – whether big (like India, Pakistan) or small (like Sri Lanka) were left on their own. The Indian Government perceived the Brexit vote initially as rather unfortunate because it would increase global instability and a weakening of the West. Indian multinationals like 'Tata', however, which had invested heavily in Britain as their gateway to Europe, saw Brexit as an economic risk. Later on, New Delhi realised also eventual policy advantages in Britain leaving the EU. The Brexit impact on Pakistan’s economy remained small so far. However, Islamabad would be well advised to formulate separate policies for post-Brexit Britain and the remaining EU-27. Sri Lanka's economic and political ties with the UK, on the other hand, are considerably stronger than with any EU country. Annual trade with the UK amounted to over 10 %. Therefore, Brexit impacted negatively on the Sri Lankan economy. Changes to strengthen economic relations with the UK to overcome post Brexit challenges were imperative. As for the COVID-19 pandemic, it soon became in all three countries not just a health emergency but also a social and economic crisis. Given the historic responsibility of the UK as a former colonial power and the renewed commitment of London to international free trade principles, it seems at least debatable whether the British government should not consider all its former colonies as equal partners concerning its foreign trade policy and grant them the same rights and facilities.French Abstract: À la suite du Brexit, Londres a approuvé une union CANZUK avec ses anciennes colonies de colons blancs, le Canada, l'Australie et la Nouvelle-Zélande. Cela se voulait une alternative valable à la perte d'accès au marché de l'UE. En revanche, les anciens dominions britanniques non blancs – qu'ils soient grands (comme l'Inde et le Pakistan) ou petits (comme le Sri Lanka) ont été laissés à eux-mêmes. Le gouvernement indien a d'abord perçu le vote sur le Brexit comme plutôt malheureux car il augmenterait l'instabilité mondiale et un affaiblissement de l'Occident. Cependant, des multinationales indiennes comme « Tata », qui avaient massivement investi en Grande-Bretagne comme porte d'entrée vers l'Europe, ont vu dans le Brexit un risque économique. Plus tard, New Delhi a également réalisé des avantages politiques éventuels en Grande-Bretagne quittant l'UE. L'impact du Brexit sur l'économie pakistanaise est resté faible jusqu'à présent. Cependant, Islamabad serait bien avisé de formuler des politiques distinctes pour la Grande-Bretagne post Brexit et le reste de l'UE-27. Les liens économiques et politiques du Sri Lanka avec le Royaume-Uni, en revanche, sont considérablement plus forts qu'avec n'importe quel pays de l'UE. Le commerce annuel avec le Royaume-Uni s'élevait à plus de 10 %. Par conséquent, le Brexit a eu un impact négatif sur l'économie Sri Lankaise. Des changements visant à renforcer les relations économiques avec le Royaume-Uni pour surmonter les défis post-Brexit étaient impératifs. Quant à la pandémie de COVID-19, elle est rapidement devenue dans les trois pays non seulement une urgence sanitaire mais aussi une crise sociale et économique. Compte tenu de la responsabilité historique du Royaume-Uni en tant qu'ancienne puissance coloniale et de l'engagement renouvelé de Londres envers les principes du libre-échange international, il semble pour le moins discutable si le gouvernement britannique ne devrait pas considérer toutes ses anciennes colonies comme des partenaires égaux concernant sa politique de commerce extérieur et accorder les mêmes droits et facilités.German Abstract: Neben dem Brexit befürwortet London eine CANZUK-Partnerschaft mit seinen ehemaligen weißen Siedlerkolonien Kanada, Australien und Neuseeland. Dies sah London als wertvolle Alternative zum verlorenen EU-Marktzugang. Im Gegensatz dazu wurden nicht-weiße ehemalige britische Herrschaftsgebiete – ob groß (wie Indien und Pakistan) oder klein (wie Sri Lanka) – sich selbst überlassen. Die indische Regierung empfand das Brexit-Votum zunächst als eher unglücklich, weil es die globale Instabilität und eine Schwächung des Westens erhöhen würde. Indische multinationale Konzerne wie „Tata“, die stark in Großbritannien als Tor nach Europa investiert hatten, sahen den Brexit jedoch als wirtschaftliches Risiko. Später erkannte Neu-Delhi auch eventuelle politische Vorteile beim Austritt Großbritanniens aus der EU. Die Auswirkungen des Brexit auf die pakistanische Wirtschaft blieben bisher gering. Islamabad wäre jedoch gut beraten, eine separate Politik für Großbritannien und die verbleibenden EU-27 nach dem Brexit zu formulieren. Die wirtschaftlichen und politischen Beziehungen Sri Lankas zum Vereinigten Königreich sind dagegen deutlich stärker als zu jedem anderen EU-Land. Der jährliche Außenandel mit Großbritannien betrug über 10 %. Daher wirkte sich der Brexit negativ auf die srilankische Wirtschaft aus. Veränderungen zur Stärkung der Wirtschaftsbeziehungen mit dem Vereinigten Königreich zur Bewältigung der Herausforderungen nach dem Brexit waren zwingend erforderlich. Die COVID-19-Pandemie entwickelte sich in allen drei Ländern schnell von einem Gesundheitsnotstand zu einer sozialen und wirtschaftlichen Krise. Angesichts der historischen Verantwortung Großbritanniens als ehemaliger Kolonialmacht und des erneuten Bekenntnisses Londons zu internationalen Freihandelsprinzipien erscheint es zumindest fraglich, ob die britische Regierung nicht alle ihre ehemaligen Kolonien als gleichberechtigte Partner in ihrer Außenhandelspolitik betrachten und ihnen gleiche Rechte und Möglichkeiten einräumen sollte.La version française de cet article peut être consultée à: http://ssrn.com/abstract=3889937

Pegadas Dixitais: Aplicación de Tecnoloxías de Intelixencia Artificial para a Detección de Percepcións de Redes Sociais (Digital Tracks: Application of Artificial Intelligence Technologies for Automatic Detection of Perceptions from Social Media. The case of the Saint James Way, with a focus on COVID-19) (preprint)

Galician Abstract: O impacto socio-económico do turismo está atraendo a atención dos estudios de políticas públicas. A actividade turística pode producir relevantes beneficios económicos, pero pode tamén producir impactos negativos nas comunidades locais, o seu patrimonio cultural así como ao seu entorno natural. A disponibilidade de información dixital pública introduce novas oportunidades para actores públicos e privados para entender mellor este impacto, fornecendo datos mellorados e ferramentas para mellor entender esta actividade. Este artigo analiza o caso das actividades turísticas relacionadas coa conexión cultural máis antiga e persistente de Europa: o Camiño de Santiago. Con este propósito, aplicamos técnicas de intelixencia artificial do campo da lingüística computacional para identificar e clasificar as percepcións positivas e negativas compartidas publicamente nas redes sociais. Os nosos resultados amosan unha percepción positiva predominante do 84% desta experiencia en 484.576 mensaxes recuperadas en 42 idiomas a partir de 2010, con avaliacións negativas orixinadas principalmente en reaccións dos residentes á degradación percibida dos seus recursos naturais e culturais. Implicar ás comunidades locais no deseño e implementación de políticas públicas e actividades privadas relacionadas co Camiño de Santiago pode axudar a aproveitar o potencial socioeconómico do turismo e contribuír á preservación dos recursos naturais e do patrimonio cultural. English Abstract: The socio-economic impact of tourism is turning the attention of public policy studies to this case. Touristic activity can produce relevant economic benefits, but it can also produce negative impacts on the local communities, their cultural heritage and natural environment. The availability of public digital information introduces new opportunities for public and private entrepeneurs to better understand this impact, providing improved data and tools to better understand their activity. This paper takes the case of the touristic activities connected to the most ancient and persistent cultural connection in Europe: the Pilgrim’s Way of St. James. With this purpose, we apply Artificial Intelligence techniques from the field of Computational Linguistics to identify and classify positive and negative perceptions publicly shared in social media. Our results show a prevailing 84% positive perception of this experience in 484,576 retrieved messages in 42 languages from 2010, with negative evaluations sourced mainly in reactions from residents to perceived degradation of their natural and cultural resources. Involving the local communities in the design and implementation of public policies and private activities connected to the St. James Way can help to harness the socio-economic potential of tourism and contribute to the preservation of natural resources and cultural heritage.

An immune-protein signature combining TRAIL, IP-10 and CRP for accurate prediction of severe COVID-19 outcome (preprint)

BACKGROUND Accurately identifying COVID-19 patients at-risk to deteriorate remains challenging. Tools integrating host-protein expression have proven useful in determining infection etiology and hold potential for prognosticating disease severity. METHODS Adults with COVID-19 were recruited at medical centers in Israel, Germany, and the United States. Severe outcome was defined as intensive care unit admission, non-invasive or invasive ventilation, or death. Tumor necrosis factor related apoptosis inducing ligand (TRAIL) and interferon gamma inducible protein-10 (IP-10; also known as CXCL10) and C-reactive protein (CRP) were measured using an analyzer providing values within 15 minutes. A signature indicating the likelihood of severe outcome was derived generating a score (0-100). Patients were assigned to 4 score bins. RESULTS Between March and November 2020, 518 COVID-19 patients were enrolled, of whom 394 were eligible, 29% meeting a severe outcome. The area under the receiver operating characteristic curve (AUC) of the signature was 0.86 (95% confidence interval: 0.81-0.91). Performance was not confounded by age, sex, or comorbidities and superior to IL-6 (AUC 0.77; p = 0.033) and CRP (AUC 0.78; p < 0.001). Likelihood of severe outcome increased significantly (p < 0.001) with higher scores. The signature differentiated patients who further deteriorated after meeting a severe outcome from those who improved (p = 0.004) and projected 14-day survival probabilities (p < 0.001). CONCLUSION The derived immune-protein signature combined with a rapid measurement platform is an accurate predictive tool for early detection of COVID-19 patients at-risk for severe outcome, facilitating timely care escalation and de-escalation and appropriate resource allocation. FUNDING MeMed funded the study

EU Consumer Law in 2020 (preprint)

The paper presents an overview of the main developments in EU consumer law in 2020. It discusses the challenges for consumer protection related to the outbreak of COVID-19 pandemic, legislative developments in the field of collective redress and digital markets as well as selected judgments of the Court of Justice, with a focus on the consumer notion, unfair terms in financial markets and consumer protection in the platform economy.The French version of this contribution will be published in “Annuaire de droit de l’Union européenne 2020” (Éditions Panthéon-Assas, forthcoming).

The increase in the risk of severity and fatality rate of covid-19 in southern Brazil after the emergence of the Variant of Concern (VOC) SARS-CoV-2 P.1 was greater among young adults without pre-existing risk conditions (preprint)

ABSTRACT Background The SARS-CoV-2 P.1 variant has been considered as variant of concern (VOC) since the end of 2020 when it was firstly identified in the Brazilian state of Amazonas and from there spread to other regions of Brazil. This variant was associated with an increase in transmissibility and worsening of the epidemiological situation in the places where it was detected. The aim of this study was to analyze the severity profile of covid-19 cases in the Rio Grande do Sul state, southern region of Brazil, before and after the emergence of the P.1 variant, considering also the context of the hospitals overload and the collapse of health services. Methods We analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informacao de Vigilancia Epidemiologica da Gripe) and compare two epidemiological periods: the first wave comprised by cases occurred during November and December 2020 (EW 45 to 53) and the second wave with cases occurred in February 2021 (EW 5 to 8), considering that in this month there was a predominance of the new variant P.1. We calculated the proportion of severe forms among the total cases of covid-19, the case fatality rates (CFR) and hospital case fatality rate (hCFR) over both waves time set using the date of onset of symptoms as a reference. We analyzed separately the patients without pre-existing conditions of risk, by age and sex. For comparison between periods, we calculated the Risk Ratio (RR) with their respective 95% confidence intervals and the p-values. Findings We observed that in the second wave there were an increase in the proportion of severe cases and covid-19 deaths among younger age groups and patients without pre-existing conditions of risk. The proportion of people under the age of 60 among the cases that evolved to death raised from 18% (670 deaths) in November and December (1st wave) to 28% (1370 deaths) in February (2nd wave). A higher proportion of patients without pre-existing risk conditions was also observed among those who evolved to death due to covid-19 in the second wave (22%, 1,077 deaths) than in the first one (13%, 489 deaths). The CFR for covid-19 increased overall and in different age groups, in both sexes. The increase occurred in a greatest intensity in the population between 20 and 59 years old and among patients without pre-existing risk conditions. Female 20 to 39 years old, with no pre-existing risk conditions, were at risk of death 5.65 times higher in February (95%CI = 2.9 - 11.03; p <0.0001) and in the age group of 40 and 59 years old, this risk was 7.7 times higher (95%CI = 5.01-11.83; p <0.0001) comparing with November-December. Interpretation Our findings showed an increase in the proportion of young people and people without previous illnesses among severe cases and deaths in the state of RS after the identification of the local transmission of variant P.1 in the state. There was also an increase in the proportion of severe cases and in the CFR, in almost all subgroups analyzed, this increase was heterogeneous in different age groups and sex. As far as we know, these are the first evidences that the P.1 variant can disproportionately increase the risk of severity and deaths among population without pre-existing diseases, suggesting related changes in pathogenicity and virulence profiles. New studies still need to be done to confirm and deepen these findings.

'KÜRESEL SALGINDA ENFLASYON PROBLEMİ: TÜRKİYE ÜZERİNE ANALİZ' (The Inflation Problem during Global Pandemic: The Analysis on Turkey) (preprint)

Turkish Abstract: Türkiye’de son yıllardaki enflasyon oranlarında ÜFE bazlı oranların %30’ların üzerine çıkması ve TÜFE bazlı enflasyonun %15’in üzerine çıkması ekonomik faaliyetlerin üzerinde olumsuz baskı yapabilir. Kovid-19 küresel salgınının olumsuz etkileri azaldığında, enflasyonun da kontrolü sürecinin de önemli olacağı görünmektedir. Türkiye’de enflasyon eğilimi, Friedman ve diğer teorisyenlerin varsayımlarını doğruladığı ortaya çıkmaktadır.English Abstract: In recent years, PPI-based rates exceeding 30% and CPI-based inflation above 15% may put negative pressure on the economic activities in Turkey. When the negative effects of the COVID-19 pandemic diminish, it seems that both the inflation control process will be important. inflation in Turkey is emerging that confirms the hypothesis of Friedman and other theorists.