bluuebunny/crossref_metadata_2025 huggingface dataset:
Competitive Neutrality and Distortion of Competition: A Conceptual View
Authors: Virtanen Martti , Valkama Pekka
Published: April 2022

Distortion of competition is a perennial concern of competition policy and a key challenge for new markets. The research problem herein elaborates on the concept of competitive neutrality by analysing its theoretical underpinnings with a view to promoting meaningful political debate and related administrative and legal reforms topical in a number of economies, including Finland. A fundamental aim of the article is to contribute to developing a theoretical framework for further studies of competitive neutrality and distortion of competition.

There is a conceptual connection between competitive neutrality and distortion of competition: competitive neutrality implies undistorted competition, where a trading partner whose purchase of a certain product the rival companies compete for will make his choice among the alternatives offered by the rival firms solely on the basis of his preferences. In that case, the preference ranking he constructs of the rivals’ products is not affected by any outside factor. Competitive neutrality is a multidimensional and disputed issue because distortions of competition have a broad institutional background. The consequences of lacking competitive neutrality and main types of policy response to competitive neutrality problems are also discussed.
The Definition of the Relevant Market and the Degree of Market Concentration in the Emerging Economies: Case Study on Brazil and Argentina
Authors: Botta Marco
Published: April 2022

The paper analyses the challenges faced by the National Competition Authorities (NCA) of the emerging economies in the application of the econometric tests usually relied on in the merger control analysis. The relevant market and the degree of market concentration are usually defined on the basis of two econometric tests, namely, the Small but Significant and Non-Transitory Price Increase (SSNIP) test and the Herfindahl-Hirschman Index (HHI). Following the example of the US and the EU Merger Guidelines, the newly established NCAs of the emerging economies often refer to these two econometric tests in their merger guidelines without taking in consideration the challenges that they will have to face in applying them. The paper is a case study on Brazil and Argentina, and it aims at defining such challenges. The paper argues in favour of granting a broader margin of discretion to the NCAs of the emerging economies in applying such tests and in favour of the possibility to introduce alternative parameters to apply such tests in comparison to those ones identified by the US and the EU Merger Guidelines.
Discretion and Prioritisation in Public Antitrust Enforcement, in Particular EU Antitrust Enforcement
Authors: Wils Wouter P. J.
Published: April 2022

This article discusses discretion and prioritisation in public antitrust enforcement, in particular in the enforcement of European Union (EU) antitrust law. First, this article defines the notion of discretion and discusses the rationale of discretion. Second, it examines the enforcement of Articles 101 and 102 of the Treaty on the Functioning of the European Union (TFEU) by the European Commission, showing that the Commission has a broad discretion concerning the question on which suspected or alleged infringements to pursue but no discretion as to the content of the antitrust prohibitions. With regard to fines, the Commission has a significant degree of discretion, although this discretion is potentially neutralized by the General Court's unlimited jurisdiction. Third, a brief comparison is made with and between the competition authorities of the EU Member States, highlighting divergence as to discretion to set priorities. The last section of this article sets out various reasons for allowing competition authorities discretion to set priorities as to which cases of suspected or alleged infringements of the antitrust prohibitions they investigate and pursue, as well as a number of risks related to prioritisation.
Antitrust Law and Administrability: Consumer versus Total Welfare
Authors: Harker Michael
Published: April 2022

This article analyses critically the debate over which is the correct welfare standard. Taking the explicit position that the choice between total welfare and consumer welfare is a political one, the focus is on their relative administrability. On that narrow criterion, neither is superior. Indeed, both have been relaxed so that they are capable of being applied in real-world contexts. This demonstrates that administrability is a core normative value underpinning antitrust law and policy.
Access to Leniency-Related Documents after Pfleiderer
Authors: Cauffman Caroline
Published: April 2022

On 14 June 2011, the Court of Justice reached its long-awaited decision in Pfleiderer. The Court decided that European Union (EU) cartel law must be interpreted as not precluding a person who has been adversely affected by an infringement of EU competition law and is seeking to obtain damages from being granted access to documents relating to a leniency procedure involving the perpetrator of that infringement. It is, however, for the courts and tribunals of the Member States, on the basis of their national law, to determine the conditions under which such access must be permitted or refused by weighing the interests protected by EU law. This contribution analyses the scope of this decision as well as its possible impact on access to leniency-related information submitted to the Commission under the EU leniency programme and on disclosure orders by non-EU courts.
The Enhanced Upward Pressure on Price Screen: Merging Markets into the Methodology
Authors: Coate Malcolm B.
Published: April 2022

Farrell and Shapiro's Upward Pressure on Price (UPP) structure is advanced as a technique to screen mergers in differentiated product markets. Lacking an ability to benchmark their analysis with experiences from relevant markets, Farrell and Shapiro propose to assume substantial efficiencies, and conclude that any positive upward pressure on price is sufficient to trigger potential concerns. This structure creates problems: the refusal to tolerate any positive UPP leads the screen to find concerns with a broad collection of mergers and an assumption of high efficiencies means the screen is unable to identify concerns for certain mergers in low price-cost margin businesses. If minor changes are made in the UPP formula and the UPP effect is adjusted for market share, it is possible to define revised UPP-based models. One of the models can be shown to be compatible with historical Federal Trade Commission (FTC) experience, given an assumed tolerance of 2%-3% upward pressure on price. Further research could improve the parameterization of a UPP-related screen and generate an even more reliable index. In some form, UPP analysis may succeed at defining the structural index for certain classes of unilateral effects mergers.
Objective Justification and Article 102 TFEU
Authors: van der Vijver Tjarda
Published: April 2022

Dominant firms that are accused of abusive behaviour may try to invoke an objective justification. If an objective justification is successfully invoked, the Article 102 of the Treaty on the Functioning of the European Union (TFEU) prohibition does not apply. The objective justification plea is useful to provide more legal certainty and coherence as to the application of Article 102 TFEU and appears to fit well within the 'effects-based' approach advocated by many.

In this article, I discuss three types of objective justification. The first source is legitimate business behaviour, which basically encompasses all actions that can be qualified as 'competition on the merits'. A second source is public interest considerations, where a higher (non-competition) goal trumps the application of Article 102 TFEU. A third source is efficiency. If the conduct leads to a net gain in consumer welfare, it may be objectively justified.

The application of objective justification may depend on many factors. The proportionality criterion, the necessity test, the dominant firm's intent and the effect of the conduct may all have a role to play. In this paper, I argue that the applicability of these conditions depend on the type of justification being invoked.
Obstruction of Investigation in EU Competition Law: Issues and Developments in the European Commissions Approach
Authors: ter Haar Maurits
Published: April 2022

This article examines the practice of the European Commission in fining undertakings for the obstruction of the Commission's investigation. For years, the Commission has fined such procedural infringements by qualifying them as an aggravating circumstance in the decision in the substantive case. In recent years, however, the Commission has increased its attention to cases of obstruction of investigation and has started fining them as autonomous infringements in standalone decisions. The Commission has, in the past few years, adopted three such decisions: E.ON Energie and Suez Environnement, both concerning the breach of a seal, and EPH and others concerning an IT-related infringement. In the appeal of E.ON Energie, the Court of Justice recently upheld the Commission's approach. While the move from circumstantial to standalone fining is commendable in itself, these standalone fines are set in a 'black box' that allows the Commission too much discretionary leeway. This raises issues of arbitrariness, proportionality and legal certainty. Therefore, it is submitted that the adoption by the Commission of fining guidelines for obstruction of investigation cases is warranted.
Legislation Blocking Antitrust Investigations and the September 2012 Russian Executive Order
Authors: Martyniszyn Marek
Published: April 2022

This article offers a typology of so-called blocking legislation and analyses its development, functions and legality under international law. It also presents and discusses the new Russian blocking Order, issued in September 2012, focusing on its possible effects on the European Commission's investigation of Gazprom's business practices (in light of EU competition law) as well as, more broadly, on foreign operations of Russian strategic enterprises.
Social Media & Competition Law
Authors: Heinemann Andreas , Gebicka Aleksandra
Published: April 2022

Virtually all of the important IT companies have been under scrutiny from the competition authorities, often on a worldwide basis. However, this is not yet true for the main actors in the field of social media. This article explores the competition law concerns of this sector focusing on the most popular platform, i.e., Facebook, and its potential abuses of dominant position under Article 102 TFEU. In the world of social media markets, market definition is complicated because of the two-sided nature of the platforms. Hence, a new version of the SSNIP test is proposed here which rejects the application of a price-based test to free Internet services and re-evaluates the importance of quality as opposed to price. Network effects and other barriers to entry are traditionally discussed for the establishment of dominance. Prohibited behaviour may be either exploitative or exclusionary. Potential exploitative conduct is reviewed from the perspective of private social media users, which highlights the controversial attitude of Facebook towards changes in administration and design by the platform, protection of information and deletion of profiles. Past IT-related case law is still relevant for the identification of exclusionary behaviour, especially as regards the rules on tying, bundling and leveraging. Developing data protection law influences restrictions on data portability. Overall, the hopeful conclusion tends to be that competition law misgivings could be allayed by a suitable adaptation of the general regulatory framework to avoid abuse in this rapidly growing area.
Revisiting the Single and Continuous Infringement of Article 101: The Significance of Anic in a New Era of Cartel Detection and Analysis
Authors: Riley David
Published: April 2022

The ability of the Commission to assess various elements of anti-competitive behaviour as manifestations of the same single and continuous infringement of Article 101, by reference to a common overriding objective, remains one of the most fundamental principles underpinning the Commission's assessment and analysis of the evidence in cartel investigations. However, whilst jurisprudence may have successfully navigated a course through the legal challenges to the single and continuous infringement, the consistency and accuracy with which the concept is discharged by the Commission and the circumstances in which its application is appropriate remain the subject of debate. Amid this uncertainty, there have nevertheless developed a number of clear and discernable reasons for practitioners to give adequate consideration to whether a party's involvement in a cartel may amount to one or several infringements of Article 101. In particular, with the Commission's assessment of the evidence in cartel investigations driven increasingly by direct engagement with the alleged participants, practitioners should be aware of the implications of the combination or disaggregation of infringements prior to making submissions under the Commission's leniency regime or engaging with the Commission through settlement discussions.
Chinas Dual Enforcement System regarding Resale Price Maintenance Agreements
Authors: Bu Qinxiu
Published: April 2022

RPM can be both beneficial and harmful to competition in various circumstances. RPM has been scrutinized with the subject of private litigation in the US, the EU and China regarding whether RPM is per se illegal or subject to the rule of reason. China's dual-mode regulatory scheme provokes more challenges and further complicates foreign companies' global expansion strategies. Following a review of the US and EU approaches to RPM, the article examines the landmark case of Ruibang v. J&J, which provides clarity and in-depth guidance on the unique Chinese system. It is argued that these administrative and legal uncertainties may not be addressed until a new judicial interpretation is provided by the Supreme People's Court.
Restrictions of Third-Party Platforms within Selective Distribution Systems
Authors: Solek Lukas , Wartinger Stefan
Published: April 2022

Third-party platforms, such as Amazon Marketplace, have not only brought a wider variety of choice to consumers, but most importantly prompted a fierce intra-brand and price competition between various suppliers and distributors resulting primarily in a lower price level. However, this development particularly affected suppliers of luxury products, who were prompted to protect the brand image and price level of their products by means of selective distribution. As a result, distributors within such distribution systems were prohibited from selling products via such platforms. As is the case for most vertical restraints, neither the European Commission nor the EU courts have dealt with this issue in their decisional practice. On the other hand, restrictions of third-party platforms have been subject to controversial case law in Germany, though the final word on the issue has still not been spoken. Against this background, this article examines the compatibility of the absolute ban of third-party platforms within selective distribution systems, as well as qualitative requirements that may exist if they are allowed with EU Competition law.
Coherence in the Application of Articles 101 and 102: A Realistic Prospect or an Elusive Goal?
Authors: Peeperkorn Luc
Published: April 2022

The shift to an effects-based approach has brought within reach coherence in the application of Articles 101 and 102, ensuring a predictable and effective policy that systematically protects competition in the interest of consumers Under Article 101, avoiding an overly wide definition of what constitute by object restrictions and the blurring of the distinction between by object and by effect restrictions is the main challenge for achieving coherence. The challenge is to ensure that individual restrictions are not defined as by object simply because in a particular market, the negative effects are obvious and/or the parties’ intention is manifestly to restrict competition. A well-functioning European Competition Network (ECN) and detailed, widely supported enforcement guidelines can help to avoid this tendency. The main challenge for coherence in the application of Article 102 is the possible creation or re-creation of a ‘soft by object category’: conduct and restrictions which are not treated as by object below the level of dominance but which become so once applied by a dominant firm. Establishing such a category would undermine coherence not only within Article 102 but also between the application of Articles 101 and 102.While case law may not always progress along the most logical route, the overall development seems still in the direction of a coherent effects-based approach.
Public Distancing and Liability in Cartel Cases: Does Distance Lend Enchantment?
Authors: Abenhaïm Marc
Published: April 2022

Although often mentioned in Court cases, the “public distancing requirement” has so far never been accepted as a defense. The key function of this requirement is to rebut the so-called Anic presumption, according to which an undertaking that has attended (even passively) an anticompetitive meeting is deemed to have participated in a “concerted practice” within the meaning of Article 101 TFEU. The key function of the “public distancing requirement” is, therefore, to rebut a presumption of liability. From this point of view, the public distancing requirement performs a central role, in that it helps resolve the inherent tension between the “Anic presumption” and the presumption of innocence. With that role in mind, this article discusses the scope, stringency and judicial review of the public distancing requirement in light of the most recent case law of the EU courts.
Mixed Policy Objectives in Merger Control: What Can Developing Countries Learn from South Africa?
Authors: Raslan Azza A.
Published: April 2022

Adopting mixed policy objectives (economic and non-economic) introduces a divergence to the ‘economic based model’ currently advocated as the basis for competition law convergence. One area of competition law where mixed policy objectives are prominently featured is merger control. South Africa is a leading example of a jurisdiction that embraces mixed objectives of competition law. In this article, we look at competition law enforcement in South Africa focusing on large mergers in the past fifteen years. The article goes beyond the conceptual, pros & cons discussion of the inclusion of public interest considerations in competition law to identify the analytical process followed in a merger situation and empirically examines the impact these considerations have had on the final decision, in comparison to other considerations usually taken into account, i.e. efficiencies/consumer welfare. The article also addresses administrability issues and challenges arising from this model. This should in turn, engage the academia in critical examination of this model, assist policymakers in making an informed policy choice and benefit practitioners in understanding how merger analysis functions in this mode
The Ripple Effects of Online Marketplace Bans
Authors: Ezrachi Ariel
Published: April 2022

The strive for tighter control of distribution, quality and price – has led an increasing number of producers to include restrictions on the use of online marketplaces in their selective distribution agreements. This article considers the effects of such restrictions and the legal approach they call for. While acknowledging the legitimacy of proportionate restrictions on distribution, the article illustrates how an absolute ban on the use of online marketplaces may have a detrimental effect on market transparency, price competition, entry and expansion. The discussion illustrates how the legitimate interests of producers may be protected through less onerous means, without the increase in consumers’ search costs and the dampening of price competition. With that in mind, it is argued that these restrictions should be analysed on a case-by-case basis and should not benefit from the Vertical Block Exemption. Furthermore, the article considers whether absent proportionality and objective justification, the harmful effect of online marketplace bans, justifies their condemnation as anticompetitive by object.
The Bitter Medicine: Competition Law and Parallel Trade in the Pharmaceutical Sector
Authors: Latronico Natalia , Perinetto Patrick Actis
Published: April 2022

The economic crisis and the growing urge of governments to cut public expenditure – particularly its heftier items, among which is pharmaceutical spending – have, in recent times, brought back on the agenda of pharmaceutical companies the issue of how to lawfully limit parallel trade of their products towards lower-price EU Member States. This objective may prove particularly hard to achieve since, from a EU competition law standpoint, parallel trade has been traditionally perceived as beneficial for consumers, as well as a force towards EU single market integration. This article aims at assessing, under a EU competition law perspective, the most common paths chosen by companies to deal with parallel trade, by relying on the (limited) case-law of EU courts and by providing a detailed and practical analysis of every available option.
Chinese SOEs under EU Competition Law
Authors: de Kok Jochem
Published: April 2022

The treatment of state-owned enterprises (SOEs) under EU competition law is a complex and controversial topic. In particular, in order to determine whether the jurisdictional thresholds are met and what the competitive impact of the transaction would be, the Commission is tasked with assessing whether SOEs enjoy independent decision-making power from the State and vis-à-vis other SOEs. SOEs that lack such independent decision-making power are considered to form part of one ‘single economic unit’. The Commission has generally avoided making definite conclusions regarding the independence of SOEs. However, recent decision practice shows that the Commission is increasingly confident in concluding that various Chinese SOEs may form part of the same economic unit. This policy is likely to bring an increasing number of transactions involving Chinese SOEs under the scope of the EU Merger Regulation (EUMR). At the same time, however, the Commission’s decision practice and soft law instruments illustrate that concentrations between SOEs which form part of the same ‘economic unit’ fall outside the scope of the Merger Regulation and that agreements between such SOEs are not subject to Article 101 TFEU.
The ECJ Ruling in Coty and the Future of Vertical Restrictions in the Internet Space
Authors: Grasso Roberto , Tzifa Georgia
Published: April 2022

This article discusses the ECJ preliminary ruling in Coty and its impact on the law of vertical restraints. Although the legal test for selective distribution cases dates back to the 1970s ECJ judgment in Metro and has since been applied rather consistently, the rapid growth of ecommerce has created serious uncertainties as to the compatibility of certain selective distribution practices with competition law. National regulators and courts throughout Europe have been enforcing the law in different and sometimes conflicting ways. This article provides a rather extensive review of such national case law and emphasizes the important contribution of the Coty judgment in clarifying the law and allowing for a more consistent enforcement of competition law in the area of vertical distribution. Finally, this article discusses some of the questions left open by Coty, which are likely to give raise to inconsistencies in the enforcement of the law at national level, such as the concept of luxury good.
Tackling Anticompetitive Parallel Conduct under Personalized Pricing
Authors: Siciliani Paolo
Published: April 2022

This article investigates under what circumstances parallel conduct under personalized pricing is anticompetitive and whether it is within the scope of competition law, depending on which dimension of consumer preference heterogeneity is targeted by rival firms. Whilst enforcement against the use of personalized pricing based on consumers willingness to pay, and the lack thereof with respect to brand preferences, is problematic due to the inherent ambiguity at the inferential phase; the exploitative use of personalized pricing based on heterogeneous levels of search costs might be beyond the reach of competition because its sustainability is not underpinned by a collusive agreement. In contrast, evidence that firms are obstructing consumers use of third-party price aggregators may provide an unambiguous signal that they are colluding to obfuscate prices.
Framing Algorithms: Competition Law and (Other) Regulatory Tools
Authors: Loderer Gaspare Tazio , Picht Peter Georg
Published: April 2022

As other fields of law, competition law is put to the test by new technologies in general and algorithmic market activity in particular. This article takes a holistic approach by looking at areas of law, namely financial regulation and data protection, which have already put in place rules and procedures to deal with issues arising from algorithms. Before making the bridge and assessing whether the application of regulatory tools from these areas might be fruitful for competition law as well, the article discusses some recent competition cases involving algorithmic market activity. It concludes with policy recommendations.
Quantitative Methods and Mergers Effects in Competition Policy: The Brazilian Case
Authors: Pires-Alves Camila C. , de Oliveira Lyra Marcos Puccioni , Gutierrez Bonfatti Marina Maria
Published: April 2022

The article aims to discuss the use of quantitative methods in quantifying merger effects as evidence, taking the particularities of the Brazilian experience and considering both technical, institutional and policy issues. Therefore, the article investigates evolution and patterns in the Brazilian institutional framework and jurisprudence in terms of technical aspects and adequacy of implementation, policy issues regarding the acceptance within the administrative tribunal and the main challenges imposed. The information collected considered all the merger cases, as far as we know, in which quantitative methods were applied by Administrative Council of Economic Defense (CADE) in order to measure, estimate or imply the merger’s potential anticompetitive effect on prices. Among the conclusions we find that the models are employed in few complex cases and mostly to sustain some restriction by the authority. We also note that the authority seems concerned about sensibility analysis, in some cases revealed by the combination of the use of different methods and/or competitive models.
Quantifying Benefits of Sustainability Agreements Under Article 101 TFEU
Authors: van der Zee Eva
Published: April 2022

Discussions at the European Commission, in academic journals as well as at conferences for academics and practitioners, indicate that there is a lack of clarity how to coincide anticompetitive sustainability agreements with the so-called economic approach of the European Commission. The current interpretation of the economic approach, most notably the European Commission guidelines issued in 2004 on the application of Article 101(3) of the Treaty on the Functioning of the European Union (TFEU), has led to situations where agreements between undertakings to stop the sale of unsustainable products or production processes have been discouraged. In this article, it is examined how the current European Commission guidelines could be improved to allow undertakings to assess their agreements in a way that is quantifiable but that goes beyond an economic approach focusing solely on monetary well-being. This article gives a legal overview of Article 101 TFEU and the guidelines, followed by an exploration of different methods to quantify agreements under Article 101(3) TFEU.

competition law, European law, well-being, sustainability, welfare, capabilities, costbenefit analysis, law and economics, psychology, Article 101 TFEU
Boundedly Rational Users and the Fable of Break-Ups: Why Breaking-Up Big Tech Companies Probably Will Not Promote Competition from Behavioural Economics Perspective
Authors: Frank Lior
Published: April 2022

The disclosure regime introduced by the EU Damages Directive is largely unprecedented in many EU Member States. Its implementation raises a number of thorny questions for both legal scholarship and practice. This contribution proposes a comparative analysis of Germany’s implementation through the lens of US discovery as a means of exposing issues, testing weaknesses, and exploring potential solutions. While the US certainly does not get everything right, it has grappled with questions of disclosure for decades. This wealth of experience and case law provides a rich vein for European (civil law) legislators and practitioners alike to mine. To this end, we analyse the key uncertainties that persist in Germany’s implementation: from the conditions and costs of disclosure, to the protections against disclosure, and the consequences of a breach. Each step of the way the US model serves as a preface to the German approach, providing context for a critical comparative analysis. We conclude with practical recommendations for the future.

antitrust, competition law, big tech companies, behavioural economics, bounded rationality, digital economy, brand name, platform and merger breakups, market power, remedies.
Self-Preferencing: Yet Another Epithet in Need of Limiting Principles
Authors: Colomo Pablo Ibáñez
Published: April 2022

Self-preferencing is central to contemporary competition law discussions, in particular in digital markets. This article considers the meaning and scope of the label. It shows, first, that favouring an affiliate is, in itself, an expression of competition on the merits. Such conduct is typically linked to the very pro-competitive benefits that are expected from horizontal and vertical integration. Second, self-preferencing is not a sound category, whether from a legal or an economic perspective. It potentially applies to conduct that differs widely in its nature, purpose and effects. The scope of the category would range from traditional instances of tying, on the one hand; to cases that would demand a competition authority to interfere with the design of a product and/or a firm’s business model, on the other.

Against this background, the use of self-preferencing as a category would require addressing some issues of principle. In the first place, it seems particularly necessary to ponder the substantive and institutional implications of abandoning indispensability as a filter limiting the exposure of the system to proactive intervention. In the second place, the need to preserve a robust assesment of effects comes across as particularly important.

Article 102 TFEU, Indispensability, Self-Preferencing, Vertical Integration, Horizontal Integration, Tying, Refusal to Deal, Product Design, Business Model, Digital
The Regulation of Injunctive Relief on Standard Essential Patents Within China’s Anti-monopoly Law
Authors: Wang Yuting
Published: April 2022

Competition concerns arising from the seeking of injunctions by FRAND-encumbered (fair, reasonable and non-discriminatory) standard essential patent (SEP) owners have become a contentious issue. This issue has attracted the attention of many competition enforcement authorities and no consensus is reached as to the compatibility of such injunctive relief with competition law. This is also a hard and challenging problem faced by China. A coherent and balanced response is urgently needed under current China’s legal framework. Therefore, this article proposes that a basic regulating approach should be established first to treat the seeking of injunctions by FRAND-encumbered SEP owners as an independent anti-competitive practice prohibited by the Anti-monopoly Law. Then, an analysis framework should be established to consider the circumstances in which and the extent to which such seeking of injunctions should be limited from the perspective of competition enforcement. The behaviour of both SEP owners and SEP users should be properly examined.

standard, standard essential patent (SEP), injunctive relief, injunction, competition, antitrust, Anti-monopoly law, competition law, fair, reasonable and non- discriminatory (FRAND), reasonable and non-discriminatory (RAND).
Think Green Before You Apply: EU Competition Law and Climate-Change Abatement
Authors: Henry David , Buhart Jacques
Published: April 2022

European Union (EU) competition law and the protection of the environment may not be the most obvious bedfellows. Nonetheless, how the EU competition rules can contribute to the EU’s mission to achieve climate neutrality by 2050 is a subject of keen debate – both by the European Commission (EC) and at Member State level. It is submitted, however, that the manner in which Article 101(3) of the Treaty on the Functioning of the European Union (TFEU) and the EU Merger Regulation (EUMR) are applied by the EC is unconducive to the achievement of the EU’s ambitious climate goals. As such, it requires adaptation. A principal, though not the only, stumbling block in this regard pertains to the EC’s insistence on the need to demonstrate economic ‘in-market’ efficiencies with a view to offsetting any alleged competition concerns. Environmental benefits, however, tend by definition to be ‘out-of-market’. Drawing upon recent developments at national level, in particular, this article therefore seeks to offer some food for thought on how the rules relating to Article 101(3) TFEU and the EUMR could be amended/ applied differently as a means of accommodating environmental benefits and supporting the 2050 climate neutrality objective.

European Green Deal, Climate neutrality, Environment, Article 101(3) TFEU, EU Merger Regulation, In-market efficiencies, Out-of-market efficiencies, CECED, UK CMA, Netherlands ACM
Musicar los balcones: resiliencia en tiempos de COVID-19
Authors: Calvo Kerman , Bejarano Ester
Published: April 2022

Este artículo analiza la musicación de los balcones durante el primer confinamiento provocado por la COVID-19 en España. A partir de un amplio análisis de corte cualitativo, se presenta la experiencia de interpretar, compartir y escuchar música en los balcones como una respuesta socialmente resiliente. La motivación para interpretar música nació de la voluntad de asistencia y ayuda; las redes tejidas en torno a la experiencia musical estimularon reacciones de empoderamiento colectivo, ayudando también a nuevos procesos de identificación con la comunidad de pertenencia.
DENETÇİ RAPORLARINDA KİLİT DENETİM KONULARININ BİLDİRİLMESİ: BORSA İSTANBUL (BİST) İNŞAAT ENDEKSİ İŞLETMELERİ ÜZERİNE BİR ARAŞTIRMA
Authors: KELEŞ Dursun
Published: April 2022

Kilit denetim konuları (KDK), bağımsız denetim sürecinde denetçilerin üzerinde odaklanacağı konular arasında en fazla önem arz eden konuları ifade etmektedir. KDK, 09.03.2017 tarih ve 30002 Sayılı Resmi Gazete’de yayımlanan “BDS 701: Kilit Denetim Konularının Bağımsız Denetçi Raporunda Bildirilmesi (BDS 701)” isimli standartta düzenlenmiştir. Bu düzenlemeyle, gerek hisseleri borsada işlem gören işletmelerin gerekse diğer bağımsız denetime tabi işletmelerin denetimleri sırasında bağımsız denetçi raporlarında KDK’lara yer verilmesi zorunluluğu getirilmiştir.Bu çalışmanın amacı, BDS 701’in KDK’ların raporlanmasına yönelik getirdiği ilke ve esasların açıklanarak, BİST İnşaat Endeksi’ndeki işletmelerin bağımsız denetçi raporlarında bildirilen KDK’ların içerik analizinin yapılmasıdır. Bu amaçla, çalışmaya konu işletmelere ilişkin 2020 ve 2021 yıllarına ait bağımsız denetçi raporlarında bildirilen KDK’lar incelenmiş ve BİST İnşaat Endeksi’nde yer alan işletmelere yönelik en fazla üzerinde durulan KDK’ların; yatırım amaçlı gayrimenkuller, hasılat ve finansal borçlar ile ilişkili hususlar olduğu tespit edilmiştir.
Alternativas en el manejo del quiste óseo solitario
Authors: Willians R. Luis R. , Carvallo A. Pedro I.
Published: April 2022

Introducción: El quiste Óseo Solitario es una lesión pseudotumoral, que aparece con frecuencia en la metáfisis de huesos largos en las primeras décadas de la vida, comprometiendo la estructura ósea; por esta razón para su resolución se presentan varias alternativas de tratamiento, tomando en cuenta la incidencia de recidivas. Objetivo: Describir el manejo del Quiste Óseo Solitario en los pacientes que acuden a la consulta de la Unidad de Tumores Musculoesqueléticos del Centro Médico Docente La Trinidad. Materiales y métodos: Revisión de historias clínicas acompañada por el protocolo de la Unidad de Tumores Musculoesqueléticos emitidas desde enero del 2017 hasta octubre 2018. Resultados: Se revisaron 18 casos con diagnóstico de Quiste Óseo Solitario evaluados en la Unidad de Tumores Musculoesqueléticos. La incidencia en cuanto edad, ubicación, y presentación radiológica coinciden con la bibliografía especializada, 10 pacientes se manejaron de la forma conservadora, 8 con tratamiento quirúrgico, mediante relleno con autoinjerto y aloinjerto, obteniendo mejores resultados con autoinjerto, disminuyendo el porcentaje de recidiva. Conclusiones: El momento para realizar la cirugía debe ser cuando la lesión se ha distanciado del núcleo de crecimiento, y el mejor sustituto óseo es el hueso autólogo.
Editorial
Authors: Rísquez Thielen Jorge
Published: April 2022

El Centro Médico Docente La Trinidad es una institución de salud integral, multidisciplinaria, de alta calidad asistencial, gerencial y académica, con un equipo humano identificado y comprometido con los valores, éticos, morales y convicción social, con alcance local y regional, bajo un modelo asistencial organizado por especialidades médicas, sustentable y sin fines de lucro, que responde a las necesidades de la comunidad, orientado al desarrollo de programas de educación e investigación en salud y medicina comunitaria. 

Desde hace 55 años, realiza aportes a tres grandes áreas: programas sociales, investigación y educación. En educación se cuenta con 10 residencias asistenciales programadas (postgrados) y más de 20 programas de perfeccionamiento profesional. Como era de esperar, cada uno de estos programas académicos están apoyados en la investigación, en búsqueda de la adquisición de nuevos conocimientos científicos que puedan ser beneficiosos en el tratamiento de nuestros pacientes. Estos trabajos son presentados anualmente en las Jornadas Científicas de la institución. Muchos de estos trabajos de investigación han recibido reconocimientos y premios, tanto a nivel nacional como a nivel internacional y han sido publicados por diferentes revistas científicas. 

El crecimiento natural de las oportunidades académicas y de trabajos de investigación nos lleva a crear una revista científica como medio de divulgación, que obedezca a los más exigentes estándares: Revista Científica Centro Médico Docente La Trinidad. Esta revista cuenta con un Comité Editorial, integrado por prestigiosas personalidades nacionales apegados a las recomendaciones internacionales (Internacional Committee of Medical Journal Editors ICMJE; World Association of Medical Editors WAME ) y Committee on Publicaction Ethics COPE. Está dirigida a todos los profesionales de la salud, docentes y estudiantes, de las especialidades médicas, odontológicas, psicológicas, bioanálisis y enfermería, en el ámbito nacional e internacional. Se publicará de manera  continua, en formato de acceso abierto, artículos originales, revisiones, casos clínicos y datos epidemiológicos producto de investigaciones en ciencias de la salud. Incluye artículos de ciencias clínicas, ciencias quirúrgicas, ciencias básicas, salud pública, tecnología aplicada a salud, actividad docente y asistencial. 

Para la Dirección de Educación e Investigación es un orgullo presentar estos primeros números.
Heterogeneidad fenotípica en el diagnóstico de MODY. Una aproximación basada en la evidencia para el diagnóstico clínico
Authors: Carrera Viñoles Fernando Javier , Aure Gestne , Camperos Paul , Silva de Casanova María Inés
Published: April 2022

Hasta la fecha se reconocen 14 genes relacionados con MODY (del acrónimo en ingles maturity onset diabetes of the young), sin embargo, es bien conocido la variabilidad epidemiológica con respecto a la Diabetes de inicio en la madurez de la juventud (MODY) que actualmente, se refiere a un grupo heterogéneo de formas monogénicas de diabetes causadas principalmente por defectos de secreción de insulina. Los subtipos MODY individuales son entidades distintas que se definen por sus mutaciones subyacentes. La MODY causada por mutaciones en la glucoquinasa (GCK-MODY, MODY2) y el factor nuclear de hepatocitos 1-alfa (HNF1A-MODY, MODY3) son las formas más prevalentes, que involucran alrededor de las tres cuartas partes de todos los pacientes con MODY. El papel de las pruebas genéticas generalizadas para detectar MODY es controvertido, dado el costo asociado, aunque eso ha disminuido drásticamente. Además, el impacto de un diagnóstico MODY definitivo puede ser significativo, especialmente para individuos jóvenes diagnosticados erróneamente con diabetes tipo 1; Estos pacientes a menudo pueden detener la insulina y hacer la transición a la terapia SU, con un control glucémico mejorado. En medio de una realidad social que impone limitaciones para establecer diagnósticos de elevada complejidad técnica como es el caso de MODY, se hace imperativo, proponer alternativas clínicas y paraclìnicas básicas que permitan establecer el mayor grado de precisión al menor costo, de esta premisa parte es revisión narrativa que permitirá al médico clínico afinar el diagnostico en diabetes.
Necesidad de tratamiento ortodóncico en un grupo de pacientes pediátricos utilizando el índice IOTN
Authors: Méndez Sánchez Pedro Miguel , Sotillo Gómez Virginia , Marcano Gisela , Limongi Isabella , Medina Díaz A. Carolina
Published: April 2022

El Índice de Necesidad de Tratamiento Ortodóncico (IOTN) permite cuantificar y determinar la necesidad de tratamiento dependiendo de la severidad de los indicadores de maloclusión. Objetivo: Determinar la necesidad de tratamiento ortodóncico en un grupo de pacientes pediátricos, que acudieron al servicio de Odontopediatría del Centro Médico Docente la Trinidad, entre marzo 2020 a agosto 2021, utilizando el índice IOTN.  Materiales y Métodos: Se realizó una investigación descriptiva y transversal, en la cual se determinó la necesidad de tratamiento ortodóncico mediante el componente dental del índice IOTN, en pacientes de 5 a 18 años de edad seleccionados a conveniencia.  Lospacientes con dentición mixta o permanente fueron evaluados clínica y fotográficamente. Participaron 4 observadores. Los datos fueron registrados y analizados con variables descriptivas. Resultados: La muestra estuvo conformada por 46 pacientes, con distribución equitativa entre sexos. El 39% de la muestra presentó ninguna (28%) o poca (11%) necesidad de tratamiento; mientras que el 61% de la muestra sí requiere tratamiento ortodóncico (necesidad moderada 33%, necesidad alta 28% y gran necesidad 4%). Los indicadores de maloclusión más prevalente fueron la sobremordida (23,9%) y desplazamiento dentario (21,7%). Conclusión: El uso del índice IOTN refleja una elevada necesidad de tratamiento ortodóncico en los pacientes pediátricos estudiados, principalmente derivada de sobremordida profunda y apiñamiento dental.
Microbiota intestinal en pacientes con Diabetes Mellitus: Análisis de la evidencia actual. Revisión sistemática
Authors: Martinez Colarossi Gianfranco Jose , Melean Lopez Zuleibis Lucia De La Chiquinquira , Carrera Viñoles Fernando Javier
Published: April 2022

La microbiota intestinal corresponde al conjunto de microorganismos que se encuentran como entes comensales del intestino, principalmente formada por bacterias Gram negativas, cuyas proporciones parecen estar asociadas con eventos inmunopatológicos que la correlacionan con enfermedades metabólicas como Diabetes Mellitus tipo 1 y 2 por lo que se analiza la evidencia actual sobre la microbiota intestinal y su relación con los dos tipos principales de Diabetes Mellitus, se indaga sobre mecanismos fisiopatológicos mediados principalmente por Lipopolisacáridos de membrana y su expresión dentro de la patogénesis de la Diabetes Mellitus tipo 1 y 2. Se realiza una revisión narrativa de 34 artículos posterior a una selección inicial de 50 a través de buscadores como PubMed, Google Scholar, CrossRef y Scielo, asociados con Microbiota Intestinal y Diabetes Mellitus tipo 1 y 2. Se relaciona principalmente con Bacteroides spp. como bacilo diabetogénico vinculado a mecanismos de autoinmunidad descritos en Diabetes Mellitus tipo 1 y en menor medida a resistencia a la insulina en Diabetes Mellitus tipo 2.  Se vinculan altas concentraciones de Akkermansia muciniphila como factor protector en el desarrollo de Diabetes Mellitus tipo 2. Se concluye que dentro de la bibliografía consultada existe una importante correlación entre la microbiota intestinal y el desarrollo de enfermedades metabólicas, conllevando a estados disbiosis que producen manifestaciones patológicas de enfermedades multifactoriales ya conocidas como lo son la Diabetes Mellitus tipo 1 y 2.
The Current Level of HIV/AIDS Knowledge and Sexual Behaviors of Students in Southern China: A Cross-Sectional Study
Authors: Li Yiting , Li Lishan , Chen Liqiu , Ding Tao , Ao Huaying
Published: April 2022

BACKGROUND: The spread of HIV/AIDS in China is predominantly driven by sexual transmission and it is a fact that HIV transmission among students is quite common, e.g., 480 000 adolescents were infected from 2000 to 2018. Our study aimed to investigate knowledge of HIV/AIDS and sexual behaviors of young students in Southern China.

METHODS: A cross-sectional study was conducted based on questionnaire. The information collected included socio-demographic characteristics, knowledge of HIV and risky sexual behaviors.

RESULTS: 9027 students were invited and 8349 were eventually enrolled in the study. The following factors were found to be associated with lower level of HIV/AIDS knowledge: female (OR: 0.757, 95% CI 0.689–0.831), residence in rural areas (OR: 0.786, 95% CI: 0.713–0.866), studying in high school (OR = 0.598, CI =0.459–0.779) and secondary vocational school (OR =0.713, CI =0.545–0.933), major in pharmacy (OR = 0.453, CI = 0.331–0.621), medicine (OR = 0.592, CI = 0.402–0.872) and others (OR = 0.671, CI = 0.518–0.871), and little participation in programs for the prevention of AIDS (OR = 0.646, CI = 0.585–0.714). Kendall correlation test showed that students who had risky sexual behaviors all had lower level of HIV/AIDS Knowledge (P < 0.05).

CONCLUSIONS: Students who have more knowledge of HIV/AIDS were generally less likely to have risky sexual behaviors. Female students and those who reside in rural areas had lower level of HIV/AIDS knowledge, indicating that we may need to pay more attention to deliver education for these cohorts. It is suggested to follow the strategies used by some developed countries to improve students’ knowledge for HIV/AIDS and prevent its transmission.