Η Αναβαλλόμενη Φορολογία και τα Ίδια Κεφάλαια των Τραπεζών.

Σκοπός της παρούσας εργασίας είναι να παρουσιαστεί η επίπτωση της αναβαλλόμενης φορολογίας στα ίδια κεφάλαια των πιστωτικών ιδρυμάτων, γεγονός που έχει περαιτέρω συνέπειες για την συνέχιση της λειτουργίας τους, καθώς, αν δεν διατηρούν το απαιτούμενο από το κανονιστικό πλαίσιο ύψος ιδίων κεφαλαίων, παραβιάζονται οι προϋποθέσεις αδειοδοσίας τους.In this study, the issue examined is the impact of deferred taxation on banks' own funds. Findings contribute to the ongoing debate regarding the inclusion of DTA in regulatory capital, as well as the literatures examining the valuation of DTA and the association between regulatory capital and credit risk

A massive hemorrhagic pleural effusion does not exclude the diagnosis of tuberculosis: a case report

We report a case of an immunocompetent 18-year-old man with a massive hemorrhagic, exudative, lymphocytic pleural effusion. Blind transthoracic pleural biopsy showed granuloma formation, while the pleural fluid culture was positive for Mycobacterium tuberculosis, confirming the diagnosis of primary tuberculous pleuritis. A massive hemorrhagic pleural effusion is extremely rare in tuberculosis, but tuberculosis is a very protean disease and should always be included in the differential diagnosis of pleural effusion

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Η Υπαγωγή στην Διαιτησία των Διαφορών που Πηγάζουν από Δημόσιες Συμβάσεις.

Η διοίκηση, άλλοτε διαθέτοντας υπερκείμενη εξουσία βούλησης και άλλοτε εμφανιζόμενη ως φορέας ισότιμης βούλησης με τον αντισυμβαλλόμενο της ιδιώτη, είτε στον νομικό τύπο της διοικητικής συμβάσεως, είτε σε αυτόν της συμβάσεως του ιδιωτικού δικαίου, αντίστοιχα, συμπεριλαμβάνει συμβατικό όρο για την επίλυση των διαφορών που εκπηγάζουν από την οικεία δημόσια σύμβαση, μέσω του ιδιωτικοδικαιϊκής συλλήψεως μηχανισμού της διαιτησίας. Σκοπός της παρούσας εργασίας είναι να περιγράψει την υπαγωγή των διαφορών που εκπηγάζουν από δημόσιες συμβάσεις στην διαιτησία και να αναδείξει κάποια από τα σημαντικότερα επιμέρους ζητήματα που ανακύπτουν.The purpose of this paper is to describe the awarding of disputes arising from public contracts to arbitration and to highlight some of the most important issues that arise

Η Φορολογική Δικονομία εντός του Κώδικα Διοικητικής Δικονομίας.

Σήμερα, ο Κώδικας Διοικητικής Δικονομίας, ως ισχύει, αριθμεί, συγκριτικά με το παρελθόν, περισσότερες ρυθμίσεις που εφαρμόζονται ειδικότερα κατά την επίλυση των διαφορών που δημιουργούνται κατά την άσκηση της φορολογικής εξουσίας του Κράτους. ‘Η ύπαρξη μιας φορολογικής δικονομίας εντός της διοικητικής δικονομίας ούτε πάντα θετική, ούτε δικαιολογημένη είναι, τραυματίζοντας από άλλη οδό την αρχή της ενότητας της δικονομικής εννόμου τάξεως’, παρατηρεί ο Καθηγητής Λαζαράτος και η συγκεκριμένη κριτική παρατήρηση αποτελεί θεμέλιο για την ανάπτυξη που θα ακολουθήσει, διερευνώντας το αν επαληθεύεται. Σκοπός της παρούσας εργασίας είναι η παρουσίαση της ισχύουσας φορολογικής δικονομίας, εντός του Κώδικα Διοικητικής Δικονομίας. Ως πρός την συστηματική κατάταξη του περιεχομένου, η εργασία αποτελείται από δύο μέρη: Στο πρώτο μέρος παρουσιάζονται οι σχετικές με την γενική διαδικασία της φορολογικής δίκης διατάξεις και στο δεύτερο μέρος οι διατάξεις σχετικά με τα ένδικα βοηθήματα και τα ένδικα μέσα της φορολογικής δίκης. Ακολουθείται κατά κύριο λόγο η ταξινόμηση και η σειρά των διατάξεων εντός του Κ.Δ.Δ. Φιλοδοξείται, περαιτέρω, η κριτική αποτίμηση της εξελικτικής πορείας των διατάξεων της φορολογικής δικονομίας εντός του πλαισίου του Κώδικα Διοικητικής Δικονομίας και η εξαγωγή συμπερασμάτων.Today, the Code of Administrative Procedure, as applicable, enumerates, in comparison with the past, more regulations applicable in particular to the settlement of disputes arising out of the exercise of State tax authority. &apos;The existence of a tax procedure within an administrative procedure is neither always positive nor justified, injuring in any other way the principle of unity of procedural law’, Professor Lazaratos observes, and this critical observation is the foundation for further development, investigating whether it is verified. The purpose of this paper is to present the current tax procedure within the Code of Administrative Procedure. In order to systematically classify the content, the work consists of two parts: The first part presents the provisions relating to the general procedure of tax proceedings and the second part provides the provisions on remedies in tax proceedings. It is further intended to critically evaluate the evolution of tax law provisions within the framework of the Code of Administrative Procedure and to draw conclusions

Is mobile learning "sustainable"? Bibliographic overview of the use of portable learning devices in environmental education for sustainability

Στο πλαίσιο της ραγδαίας εισόδου καινοτόμων τεχνολογιών στη διδακτική πράξη, η μεταχείριση κινητών συσκευών αναφαίνεται ως μια πολλά υποσχόμενη παιδαγωγική προσέγγιση, που κατευθύνει ουσιωδώς τους μαθητευομένους προς την τροχιά της βιώσιμης ανάπτυξης. Ως εκ τούτου, η παρούσα εργασία αποπειράται μια συστηματική βιβλιογραφική ανασκόπηση στον τομέα της εισαγωγής φορητών συσκευών μάθησης στην περιβαλλοντική εκπαίδευση για την αειφορία. Επισκοπήθηκαν πέντε εμπειρικές μελέτες δημοσιευμένες στο διάστημα 2017-2020, οι οποίες αναζητήθηκαν, αξιολογήθηκαν και αναλύθηκαν πληρώντας αυστηρά προδιαγεγραμμένα κριτήρια, ύστερα από την περιήγηση σε 43 διεθνείς επιστημονικές βάσεις δεδομένων και την ανάσυρση 86 συναφών πηγών. Σύμφωνα με τα κύρια συμπεράσματα της εργασίας, τα εν λόγω ηλεκτρονικά εργαλεία χρησιμοποιήθηκαν στη διδασκαλία συνδυαστικά με εφαρμογές λογισμικού και τεχνολογία κωδικών γρήγορης απόκρισης, ακολουθώντας πολυαισθητηριακές, μαθητοκεντρικές και συνεργατικές προσεγγίσεις. Η πλειοψηφία των ερευνών τεκμηριώνει ότι η παιδαγωγική χρήση των κινητών συσκευών απέφερε τη βελτίωση των οικολογικών γνώσεων και των αειφορικών στάσεων των μαθητών, όπως και της επαφής τους με τη φύση. Ανάλογα, ενισχύθηκαν η επικέντρωση των εκπαιδευομένων στη διδακτική διαδικασία, η αποδιδόμενη αξία από εκείνους σε αυτήν, αλλά και η μαθησιακή αυτεπάρκεια και διασκέδαση των μαθητευομένων. Αξιοσημείωτα, οι γνώσεις, οι στάσεις και η μαθησιακή ευχαρίστηση ήταν περισσότερο προηγμένες στους νεότερους διδασκομένους, ενώ οι μαθήτριες είχαν προβάδισμα στις ευαισθητοποιημένες στάσεις. Τα αποτελέσματα της ανασκόπησης καταδεικνύουν τη σφαιρική υποστήριξη των εκπαιδευομένων βάσει φορητών τεχνολογικών πόρων, παράλληλα με τη διασφάλιση της εμπεριστατωμένης σπουδής τους στη βιώσιμη ανάπτυξη.In the context of the rapid introduction of innovative technologies in teaching practice, the usage of mobile devices emerges as a particularly promising pedagogical approach that essentially directs apprentices toward the trajectory of sustainable development. Therefore, this work attempts a systematic literature review in the field of the introduction of portable learning devices in environmental education for sustainability. Five empirical studies published during the period 2017-2020 were reviewed, which were searched, screened and analyzed adhering to rigorously prescribed criteria, after having browsed 43 international scientific databases and accessed 86 pertinent references. According to the main conclusions of the paper, the scrutinized electronic tools were used in teaching in combination with software applications and quick response codes technology, following multisensory, student-centered and collaborative approaches. For the most part, the pedagogical usage of mobile devices has led to the improvement of students’ ecological knowledge and sustainable attitudes, as well as of their contact with nature. Comparably, the focus of the trainees on the instructional process, the value they attributed to it, and their learning self-sufficiency and amusement were strengthened. Notably, knowledge, attitudes and learning enjoyment were more advanced in younger learners, whereas female students demonstrated a lead in sensitized attitudes. The results of the review exhibit the comprehensive support of learners based on portable technological resources, whilst ensuring students’ thorough delving into the notion of sustainability