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Iron deficiency anemia (IDA) is associated with decreased bone mineral density and osteoporosis; however, studies investigating the effects of IDA in patients undergoing primary total shoulder arthroplasty (TSA) have not been well studied. The purpose of this study is to utilize a nationwide administrative claims database to investigate whether patients with diagnosed IDA undergoing primary TSA have higher rates of 1) in-hospital length of stay (LOS); 2) medical complications; and 3) implant-related complications METHODS: A retrospective review from 2005 to 2014 was conducted using the Medicare Standard Analytical Files. Patients with IDA undergoing primary TSA were identified and matched to controls without IDA, in a 1:5 ratio by age, sex, and medical comorbidities. Outcomes analyzed included in-hospital LOS and 90-day medical and implant-related complications. Mann-Whitney-U tests compared in-hospital LOS, and multivariate logistic regression was used to calculate odds-ratios (OR) on the effects of IDA on postoperative complications after adjusting for age, sex, and Elixhauser-Comorbidity Index.A total of 17,689 patients with IDA and 88,445 without IDA participated in the matched-cohort analysis, with no differences in age, gender, and comorbidities (p=0.99). IDA patients were found to have significantly longer in-hospital LOS (3-days vs. 2-days, p0.0001). IDA patients were also found to have significantly higher odds of 90-day implant-related complications (OR: 1.65, p0.0001), such as peri-prosthetic joint infections (OR: 1.80, p0.0001) and 90-day medical complications (OR: 2.87, p0.0001), including blood transfusions (OR: 10.37, p0.0001).Patients with IDA undergoing primary TSA have significantly longer in-hospital LOS, and medical and implant-related complications. Patients were 10 times more likely to undergo a blood transfusion and 2 times more likely to have a peri-prosthetic fracture.

Phase angle (PhA) has been identified as a poor prognostic factor in patients with COVID-19. This study aimed to achieve a systematic review, where we discussed the potential role of PhA value as a prognostic marker of adverse clinical outcomes such as mortality and complication in hospitalized with SARS-CoV2 infection and established the strength of recommendations for use. A systematic literature review with meta-analysis was done in the main electronic databases from 2020 to January 2023. The selected articles had to investigate adverse consequences of the COVID-19 population and raw bioimpedance parameters such as PhA and published in peer-reviewed journals. GRADE tools regarded the quality of the methodology. The review protocol was registered in PROSPERO. Only eight studies, 483 studies, were eligible for the analysis. In general, differences in PhA were seen between the comparative study groups. Patients with a low PhA experienced poor outcomes. A low PhA was associated with a significantly increased mortality risk [RR: 2.44; 95% CI (1.20–4.99), p = 0.01; I2 = 79% (p = 0.0008)] and higher complications risk [OR: 3.47, 95% CI (1.16 – 10.37), p = 0.03; I2 = 82% (p = 0.004)] in COVID-19 patients. Our analysis showed four evidence-based recommendations on the prognostic value of PhA with two strong recommendations, one of moderate and another of low-moderate quality, for predicting mortality and complications, respectively. We recommend using PhA as a prognostic marker for mortality and complications in this population. Although the results are promising, future studies must identify the PhA cut-off to guide therapeutic decisions more precisely.Registration code in PROSPERO: CRD42023391044

This study aimed to assess the cost-effectiveness of pembrolizumab monotherapy in the first-line treatment of advanced non-small cell lung cancer (NSCLC) in adults whose tumors expressed programmed death-ligand 1 (PD-L1) with a tumor proportion score (TPS) ≥ 50% in the Irish healthcare setting.Effectiveness inputs were derived from the 5-year analysis of KEYNOTE-024 phase III clinical trial. The intervention was pembrolizumab monotherapy; the comparator was a weighted average of the 5 chemotherapy regimens from the trial. The population included those with previously untreated advanced PD-L1 TPS ≥ 50% NSCLC. A de novo partitioned survival model was developed. Survival modeling was done using Bayesian model averaging on fitted parametric functions. Costs included drug acquisition, treatment initiation, administration and monitoring, adverse events, subsequent treatments, and terminal care. Costs and health state utilities were sourced from the literature and Irish sources. The model had a 20-year time horizon. The perspective taken was the Health Service Executive. A 4% discount rate was applied. Outcomes were expressed as an incremental cost-effectiveness ratio (ICER), measured in terms of incremental costs per quality-adjusted life-year (QALY). Probabilistic sensitivity analysis and 1-way sensitivity analyses were conducted.The model estimated a base case ICER of €54 237 per QALY. The probabilistic sensitivity analysis estimated an average ICER of €54 568 per QALY and a 11% probability of cost-effectiveness at the Irish cost-effectiveness threshold of €45 000 per QALY.At the current list price, first-line pembrolizumab monotherapy is not considered cost-effective for the treatment of advanced PD-L1 TPS ≥ 50% NSCLC in the Irish healthcare setting.

Lactic acidosis is a clinical status related to clinical worsening. Actually, higher levels of lactate is a well-established trigger of emergency situations. The aim of this work is to build-up a prehospital early warning score to predict 2-day mortality and intensive care unit (ICU) admission, constructed with other components of the lactic acidosis besides the lactate.Prospective, multicenter, observational, derivation-validation cohort study of adults evacuated by ambulance and admitted to emergency department with acute diseases, between January 1st, 2020 and December 31st, 2021. Including six advanced life support, thirty-eight basic life support units, referring to four hospitals (Spain). The primary and secondary outcome of the study were 2-day all-cause mortality and ICU-admission. The prehospital lactic acidosis (PLA) score was derived from the analysis of prehospital blood parameters associated with the outcome using a logistic regression. The calibration, clinical utility, and discrimination of PLA were determined and compared to the performance of each component of the score alone.A total of 3334 patients were enrolled. The final PLA score included: lactate, pCO2, and pH. For 2-day mortality, the PLA showed an AUC of 0.941 (95%CI: 0.914-0.967), a better performance in calibration, and a higher net benefit as compared to the other score components alone. For the ICU admission, the PLA only showed a better performance for AUC: 0.75 (95%CI: 0.706-0.794).Our results showed that PLA predicts 2-day mortality better than other lactic acidosis components alone. Including PLA score in prehospital setting could improve emergency services decision-making.

We assess if a 'donut effect' has occurred in Spain during the COVID-19 pandemic. Our results show a synchronized 30% drop in housing purchases during the national lockdown in 2020, followed by a significant increase from 2021 across the rural-urban continuum, including core cities, suburbs, towns and rural areas, exceeding pre-pandemic levels. We thus found no evidence of a ‘donut effect’ in Spain.

El propósito de este artículo es el poder mostrar los aportes de la gobernanza digital para una gestión pública local inteligente a través de la interpretación por parte de los investigadores, teniendo como paradigma de investigación la fenomenología-interpretativa, y con un enfoque cualitativo. Desde lo inductivo, se obtiene un recorrido heurístico del conocimiento sustentado en la propuesta que establece el método hermenéutico (comprender e interpretar) de construir un discurso desde la base de la situación de origen. Se consideró como unidad de análisis al Gobierno Autónomo Descentralizado del cantón San Vicente de la Provincia de Manabí, espacio que permitió la observación directa, manteniendo un acercamiento objetivo, con una visión de los acontecimientos desde su naturalidad, registrando cada componente y atributo que le hace única. Además, los investigadores lograron contar con los aportes de dos reconocidas personalidades de la academia cuyos aportes dentro del ámbito de estudio de la gobernanza y los gobiernos locales han resultado de gran ilustración; esto a través de la aplicación de una entrevista semiestructurada permitiendo contrastar y triangular con las perspectivas de los autores, obteniendo elementos significativos que sustentan los componentes digital e inteligente. El proceso de análisis de los hallazgos se da desde la propuesta de la Teoría Fundamentada, mediante la instrumentación de la matriz axial (códigos sustantivos, códigos axiales, conceptos sustantivos) permitiendo que surja una categoría central denominada Gobernanza digital para una gestión pública local inteligente, siendo esta considerada por los investigadores como una contribución para la buena praxis dentro de la administración pública.

Background & aims Severe acute COVID-19 has taken on pandemic proportions with growing interest in identification of prognostic factors for mortality. Standardized bioelectrical impedance (BI) phase angle (SPhA), which is PhA adjusted by age and sex, has been related to mortality in patients with several diseases but never investigated in COVID-19. Inflammation, a consequence of COVID-19 infection, affects fluid status (hydration) and can be identified with PhA. The aim of this study was to determine the predictive role of PhA on 90 days survival of adults with COVID-19. Methods We studied 127 consecutive patients diagnosed with COVID-19. BI measurements determined with a 50 kHz phase-sensitive BI device, body composition parameters and laboratory markers were evaluated as predictors of mortality. Results Non-surviving COVID-19 patients had significantly lower PhA and SPhA values (p

This research paper aims to analyse the visibility, scientific production and educational impact of teaching spoken language between 2010 and 2020 by using bibliometric techniques. The Scopus and Web of Science databases have been used in order to carry out the study. We have selected articles published in journals included in the thematic category of Teaching Oral Communication in the decade 2010-2020. Out of 2677 articles, only 457 offer relevant data for our analysis, and of these, no more than 155 documents are written by Spanish authors. The lack of articles on this topic seems obvious, which consequently leads to the conclusion that there is a high need to conduct rigorous research on the subject and design educational models that allow teachers to implement efficient didactic methods and strategies when teaching oral communication in the current Spanish educational system.

El propósito de la investigación fue el interpretar los principios del gobierno abierto que dan impulso a una administración pública digital e inteligente en el GAD Provincial de Manabí (Ecuador); el enfoque metodológico ha sido cualitativo, apoyada en el método inductivo, cuyo nivel de profundidad es de tipo descriptiva, con un trabajo de campo no experimental, la revisión documental ha servido de estrategia para el sustento del discurso por parte de los investigadores; además, como estrategia de análisis la misma se basó en las fases propuestas por la Teoría Fundamentada (Strauss y Corbin) diseñada para casos de estudios; por otro lado, el método hermenéutico (analítico-interpretativo) contribuyó con la identificación del objeto de estudio al permitir darle una forma compresiva e interpretativa a partir del discurso expresado por los informantes claves -académicos e investigadores- mediante una entrevista semi estructurada (en profundidad). Entre los hallazgos encontrados se encuentran tres vertientes que dan oportunidad a una idea de buenas praxis dentro de la gestión del GAD Provincial de Manabí; estas vertientes sean generado a raíz de un proceso de categorización a partir de una muy cuidadosa triangulación discursiva: teóricos, informantes e investigadores, estas vertientes son: Gobierno abierto democrático, Estado abierto y Modelo de gobernanza abierta y colaborativa. Sin dudas, se hace necesario abrir paso a una administración pública digital e inteligente, pertinente para gestionar la complejidad del presente.

Background: Direct observation is an invaluable tool for assessing clinical skills. However, it is unclear whether trainees are regularly observed on internal medicine clinical teaching units (CTUs). Methods: A web-based survey was distributed to medical students and residents completing rotations on inpatient internal medicine CTUs. Participants recorded the frequency of direct observation and observational feedback received over the past week. Results: Of the 189 survey respondents, 76% reported receiving direct observation at least once. On average, six skill-specific observations were reported by each learner, with an average of two different skills being observed. Bedside clinical decision-making and physical examination skills were observed most frequently. Feedback was least often provided after the direct observation of physical examination and communication skills.Conclusions: A quarter of trainees were not regularly observed at the internal medicine CTUs. The optimal frequency of direct observation requires further study. Résumé Contexte: L’observation directe est un outil précieux d’évaluation des compétences cliniques. On ne sait pas si les stagiaires sont observés régulièrement dans les unités d’enseignement clinique (UEC) de médecine interne. Méthodologie: Un sondage en ligne a été transmis à des étudiants en médecine et à des résidents qui font des stages dans des UEC de médecine interne en milieu hospitalier. Les participants ont consigné la fréquence des observations directes et des rétroactions d’observations reçues au cours de la semaine précédente. Résultats: Sur les 189 répondants au sondage, 76 % ont déclaré avoir reçu une observation directe au moins une fois. En moyenne, six observations sur une compétence particulière ont été déclarées par chaque apprenant, le nombre moyen decompétences différences qui ont été observées étant de deux. Les compétences relatives à la prise de décision clinique au chevet du patient et à l’examen physique ont fait le plus souvent l’objet d’une observation. Une rétroaction est survenue le moins souvent après l’observation directe de l’examen physique et de l’aptitude à communiquer. Conclusions: Le quart des stagiaires n’ont pas été observés régulièrement à l’UEC de médecine interne. La fréquence optimale de l’observation directe doit faire l’objet d’une étude approfondie.

ObjectivesTo assess the risk of major adverse cardiovascular events (MACEs) and venous thromboembolism events (VTEs) among patients initiating a Janus kinase inhibitor (JAKi) (tofacitinib and baricitinib) versus adalimumab in a large real-world population of patients with rheumatoid arthritis.MethodsWe conducted a nationwide population-based cohort study of the French national health data system, the exposed group initiating a JAKi and non-exposed group initiating adalimumab. We included all individuals who had their first dispensation of a JAKi or adalimumab between 1 July 2017 and 31 May 2021 and had rheumatoid arthritis. The primary endpoints were the occurrence of a MACE or VTE. Weighted hazard ratio (HRw) values were estimated with the inverse probability of treatment weighting method to account for confounding factors with concomitant administration of methotrexate as a time-varying variable.ResultsThe cohort included 15 835 patients: 8481 and 7354 in the exposed and non-exposed groups (mean age 59.3 and 55.3 years, female 78.3% and 71.2%, respectively). During follow-up, 54 and 35 MACEs and 75 and 32 VTEs occurred in the exposed and non-exposed groups, respectively. Risk of MACEs for the exposed versus non-exposed group was not significant: HRw 1.0 (95% CI 0.7 to 1.5) (p=0.99), nor was risk of VTEs significant: HRw 1.1 (0.7 to 1.6) (p=0.63). Despite a lack of power, results were consistent among patients aged 65 years or older with at least one cardiovascular risk factor.ConclusionsThis study provides reassuring data regarding the risks of MACEs and VTEs in patients initiating a JAKi versus adalimumab, including patients at high risk of cardiovascular diseases.

The evidence about the use of natriuretic peptides (NP) to predict mortality in the pre-hospital setting is limited. The main objective of this study is to assess the ability of point-of-care testing (POCT) N-terminal portion of B-type natriuretic peptide (NT-proBNP) to predict 2-day in-hospital mortality of acute cardiovascular diseases (ACVD).We conducted a multicentric, prospective, observational study in adults with ACVD transferred by ambulance to emergency departments (ED). The primary outcome was 2-day in-hospital mortality. The discrimination capacity of the NT-proBNP was performed through a prediction model trained using a derivation cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic on a validation cohort.A total of 1006 patients were recruited. The median age was 75 (IQR 63-84) years and 421 (41.85%) were females. The 2-day in-hospital mortality was 5.8% (58 cases). The predictive validity of NT-proBNP, for 2-day mortality reached the following AUC: 0.823 (95%CI: 0.758-0.889, p 0.001), and the optimal specificity and sensitivity were 73.1 and 82.7. Predictive power of NT-proBNP obtained an AUC 0.549 (95%CI: 0.432-0.865, p 0.215) for acute heart failure, AUC 0.893 (95%CI: 0.617-0.97, p 0.001) for ischemic heart disease, AUC 0.714 (95%CI: 0.55-0.87, p = 0.0069) for arrhythmia and AUC 0.927 (95%CI: 0.877-0.978, p 0,001) for syncope.POCT NT-proBNP has proven to be a strong predictor of early mortality in ACVD, showing an excellent predictive capacity in cases of syncope. However, this biomarker does not appear to be useful for predicting outcome in patients with acute heart failure.

Adults with intellectual and developmental disabilities (IDD) are prescribed more medications than the general population, placing them at significantly higher risk for issues due to taking multiple medications (polypharmacy). There are currently no clear national standards for the administration of medications given this risk. The following policy analysis explores state policies related to prescription medication oversight. This analysis pays particular attention to the use of medications that alter one’s mental state (psychotropics) among people with IDD who receive home and community-based services (HCBS) in the United States. The article outlines current efforts implemented to reduce medication-related risks for people with IDD in three states and explores the similarities and differences across strategies. This policy analysis aims to initiate conversation and encourage further consideration and deliberation necessary to move toward clear and concrete guidelines for the oversight of medication regimens.

El propósito de la investigación ha sido el interpretar los nuevos enfoques en gestión pública para una gobernanza institucional inteligente, teniendo como unidad de estudio el Ministerio de Producción, Comercio Exterior, Inversiones y Pesca (Ecuador); el diseño de la investigación es tipo fenomenológico interpretativo con un enfoque cualitativo, de dimensión inductiva, con un nivel de profundidad descriptiva, siendo a su vez de campo no experimental, la revisión documental se plantea como estrategia para la obtención de postulados teóricos, informes y relatos narrados por informantes claves; a su vez, la estrategia de análisis estuvo fundamentada en las fases propuestas por la Teoría Fundamentada, en las que se representan los códigos sustantivos, códigos axiales, conceptos sustantivos hasta llegar a la categoría central; así como del uso de la praxis hermenéutica (analítico-interpretativo) con el objeto de dar forma interpretativa al discurso expresado por los entrevistados -expertos académicos e investigadores- a través de una entrevista en profundidad (semi estructurada). Entre los hallazgos encontrados se encuentra la categoría Gestión pública 4.0: Gobernanza institucional inteligente, la cual se presenta como una propuesta de buena praxis de gestión pública, la cual surgió de la triangulación entre la teoría consultada, la narrativa discursiva de los informantes claves y los criterios propios de los investigadores, dando un espacio al interaccionismo simbólico. Entre las principales reflexiones se encuentra la necesidad de incorporar una gobernanza institucional en la gestión pública como praxis de participación ciudadana directa y comprometida. Palabras clave: Gestión pública, gobernanza, Teoría Fundamentada.

El propósito de la investigación ha sido el interpretar el aporte de la gobernanza dentro el nuevo modelo post burocrático en la gestión pública local, teniendo como unidad de estudio al Gobierno Autónomo Descentralizado del cantón San Vicente de la Provincia de Manabí (Ecuador); el diseño de la investigación es tipo fenomenológico-interpretativo con un enfoque cualitativo, con un nivel de profundidad descriptiva, siendo a su vez de campo y no experimental, la revisión documental se planteó como estrategia para la obtención de postulados teóricos, informes y relatos narrados por los informantes claves (entrevistados); a su vez, la estrategia de análisis estuvo basada en las fases propuestas por la Teoría Fundamentada, en las que se representan los códigos sustantivos, códigos axiales, conceptos sustantivos hasta llegar a la categoría central; así como del uso de la praxis hermenéutica (analítico-interpretativo) con el objeto de dar forma interpretativa al discurso expresado por los entrevistados -expertos académicos e investigadores- a través de una entrevista en profundidad. Entre los hallazgos encontrados se encuentra la categoría central denominada: Postburocracia de la gestión pública local desde la innovación gerencial y tecnológica, la cual se plantea como una propuesta de buena praxis para gestión pública local, esta surgió de la triangulación entre la teoría revisada, la narrativa discursiva de los informantes claves y los criterios propios de los investigadores, dando un espacio al interaccionismo simbólico. Entre las principales reflexiones se encuentra el prepararse para una nueva administración pública en la que la virtualidad y la inteligencia artificial estarán presentes.

Mencuci tangan dengan memakai sabun dan air bersih yang mengalir merupakan suatu upaya pencegahan penyakit melalui tindakan sanitasi, kegiatan tersebut juga termasuk dalam kategori Perilaku Hidup Bersih dan Sehat (PHBS). Mencuci tangan sangat penting diterapkan karena terbukti efektif untuk mencegah pengendalian infeksi dan penyebaran penyakit. Berdasarkan survei yang sudah dilakukan peneliti masih banyak siswa-siswi di SDN Sukabumi 2 Kota Probolinggo yang belum bisa menerapkan cuci tangan sebelum dan sesudah makan. Kegiatan Tri Bhakti menggunakan metode “pendidikan masyarakat”. Dengan memberikan penjelasan mengenai pola Perilaku Hidup Bersih dan Sehat agar mengetahui cara dalam menjaga kebersihan diri dan lingkungannya. Setelah itu, peserta didik mempraktekkan secara langsung penerapan mencuci tangan untuk menjaga kesehatan diri. Kegiatan ini bertujuan memberi pelatihan dan praktikum secara langsung serta memberikan gambaran cara mencuci tangan yang benar pada peserta didik Kelas 4 dan 5 sejumlah 40 anak di SDN Sukabumi 2 Kota Probolinggo. Dalam pelaksanaan kegiatan Tri Bhakti dapat berjalan dengan lancar sehingga peserta didik memperoleh peningkatan pengetahuan, peserta didik dapat mengetahui dan menerapkan materi yang telah dipaparkan. Peserta didik diminta dengan langsung menerapkan Langkah dalam mencuci tangan dengan benar sesuai dengan standar WHO. Selain itu peserta didik dapat memberkan contoh cara menajaga kebersihan lingkungan upaya Perilaku Hidup Bersih dan Sehat (PHBS) dengan membuang sampah pada tempatnya. Kegiatan Tri Bhakti ini membawa dampak baik untuk peserta didik tingkatan Sekolah Dasar , karena mereka menjadi tahu pola Perilaku Hidup Bersih dan Sehat (PHBS). Kegiatan ini memberikan pengalaman baru pada siswa-siswi SDN Sukabumi 2 Kota Probolinggo dalam menjaga kebersihan diri dan lingkungan.Mencuci tangan dengan memakai sabun dan air bersih yang mengalir merupakan suatu upaya pencegahan penyakit melalui tindakan sanitasi, kegiatan tersebut juga termasuk dalam kategori Perilaku Hidup Bersih dan Sehat (PHBS). Mencuci tangan sangat penting diterapkan karena terbukti efektif untuk mencegah pengendalian infeksi dan penyebaran penyakit. Berdasarkan survei yang sudah dilakukan peneliti masih banyak siswa-siswi di SDN Sukabumi 2 Kota Probolinggo yang belum bisa menerapkan cuci tangan sebelum dan sesudah makan. Kegiatan Tri Bhakti menggunakan metode “pendidikan masyarakat”. Dengan memberikan penjelasan mengenai pola Perilaku Hidup Bersih dan Sehat agar mengetahui cara dalam menjaga kebersihan diri dan lingkungannya. Setelah itu, peserta didik mempraktekkan secara langsung penerapan mencuci tangan untuk menjaga kesehatan diri. Kegiatan ini bertujuan memberi pelatihan dan praktikum secara langsung serta memberikan gambaran cara mencuci tangan yang benar pada peserta didik Kelas 4 dan 5 sejumlah 40 anak di SDN Sukabumi 2 Kota Probolinggo. Dalam pelaksanaan kegiatan Tri Bhakti dapat berjalan dengan lancar sehingga peserta didik memperoleh peningkatan pengetahuan, peserta didik dapat mengetahui dan menerapkan materi yang telah dipaparkan. Peserta didik diminta dengan langsung menerapkan Langkah dalam mencuci tangan dengan benar sesuai dengan standar WHO. Selain itu peserta didik dapat memberkan contoh cara menajaga kebersihan lingkungan upaya Perilaku Hidup Bersih dan Sehat (PHBS) dengan membuang sampah pada tempatnya. Kegiatan Tri Bhakti ini membawa dampak baik untuk peserta didik tingkatan Sekolah Dasar , karena mereka menjadi tahu pola Perilaku Hidup Bersih dan Sehat (PHBS). Kegiatan ini memberikan pengalaman baru pada siswa-siswi SDN Sukabumi 2 Kota Probolinggo dalam menjaga kebersihan diri dan lingkungan

La presente investigación tuvo como objetivo principal analizar las estrategias empresariales basadas en la diferenciación del producto que generan ventajas competitivas para las microempresas alimenticias comunitarias del cantón Santa Ana. Como parte del desarrollo del estudio se utilizó una metodología de carácter descriptivo, con enfoque mixto (cualitativo/cuantitativo) ya que se emplearon técnicas e instrumentos de recolección de información como la ficha de observación, entrevista y encuesta. La ficha de observación se aplicó a través de una lista de chequeo en visitas realizadas a las instalaciones de la microempresa, mientras que la entrevista estuvo dirigida a la Presidenta de la Asociación San Miguel de Palo Largo y de la Microempresa NATUPAL. Para el desarrollo de la encuesta se tomó como población a las 28 socias de la microempresa NATUPAL, a las cuales se les aplicó el formulario. Dentro de los resultados obtenidos se pudo evidenciar la situación actual de la empresa, así como conocer cuáles son las estrategias que aplican para el desarrollo de sus actividades.

El estudio se concentró en determinar las estrategias de control interno que permiten la mejora en la gestión de facturación en microempresas comerciales y artesanales en el cantón Portoviejo con la finalidad de realizar un análisis con base a los resultados obtenidos. Debido a esto, se aplicaron métodos por medio de una investigación no experimental con un enfoque mixto (cualitativo/cuantitativo); para ello, se aplicaron herramientas de recolección de datos como la encuesta y la entrevista semiestructurada; la muestra resultante para su implementación estuvo conformada por un total de 68 microempresarios. Los resultados mostraron las principales estrategias de control interno adoptadas por las microempresas comerciales y artesanales entre las cuales se encuentran procesos de facturación, sistema de planificación de recursos empresariales (ERP) y control de procesos.

El presente estudio tiene como objetivo principal la identificación de estrategias de RSE implementadas por las microempresas recicladoras del cantón El Carmen con la finalidad de realizar un análisis acerca de su aplicación y como son los procesos en la gestión de residuos. Para ello, se aplicó una metodología de tipo descriptiva basándose en un enfoque mixto (cualitativo/cuantitativo) debido que se utilizaron instrumentos de recolección de información como la encuesta y la entrevista semi estructurada, la población estuvo conformada por un total de 16 colaboradores de las microempresas recicladoras para efectos de la encuesta; y para la entrevista la misma se realizó a los gerentes de la Microempresa “YO RECICLO” y la Microempresa de reciclaje “STEPHANNY”. Los resultados mostraron cierto nivel de desconocimiento de las RSE por parte de los trabajadores, del mismo modo se identificaron las estrategias aplicadas y los procesos llevados a cabo por las empresas en el tratamiento de residuos.

Perineal carcinoma of unknown origin is a rare and aggressive disease, so an early diagnosis and adequate treatment are essential to prevent its progression. We report the first series of cases of perineal carcinoma of unknown origin: (I) a 62-year-old male patient being followed up for a urethral stricture treated with periodic dilations with subsequent development of perineal abscesses and perineal carcinoma; (II) a 67-year-old male patient who consults for urinary discomfort associated with a perineal abscess. Recurrence of the abscess in the first month revealed the presence of an underlying perineal carcinoma; (III) a 78-year-old male patient that underwent urethroplasty with graft with subsequent regimen of periodical dilations. Recurrent formation of perianal abscesses revealed the presence of an underlying perineal carcinoma; and (IV) a 78-year-old male patient with history of in situ penile carcinoma treated by glans resurfacing. He consulted for penile pain, and imaging tests revealed a perineal abscess adjacent to the left corpus cavernosum. The core needle biopsy revealed a squamous cell carcinoma. Penile exploration and negative glans biopsy ruled out possible recurrence of penile carcinoma. The form of presentation of the disease has been very similar in all patients, demonstrating the presence of perineal abscess in all cases. Two patients had inguinal lymph node disease at diagnosis. All patients were treated by surgery, and three of them required adjuvant systemic treatment. Surgery combined with systemic treatment is probably the best option if the patient’s conditions allow it.

Este estudio busca dentro de la tradición republicana, y más concretamente en el pensamiento de Rousseau, la inspiración para un problema permanente, a saber, el de la relación entre propiedad privada y libertad. Ello es así porque la propiedad, del mismo modo que puede servir de garantía a la independencia del ciudadano, cuando es excesiva se convierte en un peligro para la libertad de los otros. Mientras que muchos filósofos de la Política justifican que solo los propietarios sean ciudadanos, otros como Rousseau defienden que todos los ciudadanos deben ser propietarios, aunque se trate de una propiedad limitada y basada en el trabajo. Para el republicanismo de nuestro tiempo, el lema rousseauniano de que ningún ciudadano sea tan rico que pueda comprar a otro, ni tan pobre que se vea obligado a venderse, sigue siendo un principio válido. El republicanismo clásico privilegiaba la propiedad de la tierra, al considerar que los pequeños propietarios eran los mejores ciudadanos. Sin embargo, las condiciones económicas actuales obligan a buscar fórmulas más imaginativas para garantizar el mismo ideal republicano de la autonomía y la no dominación.

Patients with gastroenteropancreatic neuroendocrine tumors (GEPNET) can suffer from malnutrition. This is the first descriptive study of morfo-functional evaluation in GEPNET.To describe a morfo-functional evaluation, and to compare with reference population available, and to correlate different nutritional parameters. Moreover, to compare nutritional evaluation in our study with another same location non-neuroendocrine tumors.A retrospective observational study, 50 patients with GEPNET, medium age 61 years. It was collected clinico-pathological characteristics and nutritional status was assessed by anthropometric, laboratory test, bioelectrical impedance analysis, phase angle, hand grip strength, and rectus femoris ultrasound for the assessment of muscle mass. We used SPSS statistics to describe and to analyze correlations of different variables.Most frequent location of tumor was pancreas and small bowel, tumor grade 1 and advance stage. In morfo-functional evaluation highlighted: a low fat mass percentage (23,5 vs 34,4%), low muscle mass percentage (36,5 vs 41,2%) and low body mass cell percentage (40,4 vs 48,8%) compared with reference population available by sex and age. Standarized phase angle by sex and age result as positive (+0,851). There was no difference in hand grip strength compared with reference population. After a review of differents studies available, phase angle and hand grip strength of non neuroendocrine tumors in same location, could suggest a minor affection of nutritional state in our GEPNET sample. A positive correlation was observed between non classic methods of nutritional evaluation such as bioelectrical impedance analysis, hand grip strength and rectus femoris ultrasound.Patients with gastroenteropancreatic neuroendocrine tumors (GEPNET) show a moderate affection of nutritional status in comparison to general population. Morphofunctional assessment provide us a precise knowledge about nutritional status.

Los estereotipos asociados a las personas mayores y los procesos de envejecimiento constituyen una preocupación sanitaria y social relacionada con el envejecimiento activo (OMS, 2016). Las personas mayores han sido objeto de preocupación en la pandemia por la COVID-19, no solo por su mayor riesgo de mortalidad y contagio, sino por el riesgo a ser discriminado y desarrollar sentimientos de tristeza e insatisfacción. Además, las mujeres mayores de 50 años han sido uno de los grupos que más ha consultado y pedido ayuda durante la pandemia (Cruz Roja Española). Los objetivos de este estudio han sido: conocer la actitud hacia el envejecimiento en mujeres mayores de 50 años, estudiar la relación entre la actitud hacia el envejecimiento, el funcionamiento ejecutivo, la depresión y la satisfacción con la vida. Los participantes han sido 139 mujeres mayores de 50 años. Los instrumentos utilizados han sido: Attitudes to Ageing Questionnaire (Laidlaw, et al., 2007), Satisfacción con la vida (Dienner, 1985), Funcionamiento prefrontal (ISP-20, Pedrero-Pérez, et al., 2015), y A Self-Report Depression (Radloff, 1977). Los datos fueron recogidos en noviembre de 2020 mediante un formulario on line. Se han obtenido correlaciones que indican que una actitud negativa hacia el envejecimiento se relaciona con menor satisfacción con la vida, mayor puntuación en depresión y peor funcionamiento ejecutivo. Se discuten las implicaciones de los resultados en la programación e inclusión de variables neuropsicológicas en los programas de atención a mujeres mayores en tiempos de crisis sanitarias.

Mitochondria play an important role in both normal heart function and disease etiology. We report analysis of common genetic variations contributing to mitochondrial and heart functions using an integrative proteomics approach in a panel of inbred mouse strains called the Hybrid Mouse Diversity Panel (HMDP). We performed a whole heart proteome study in the HMDP (72 strains, n=2-3 mice) and retrieved 848 mitochondrial proteins (quantified in ≥50 strains). High-resolution association mapping on their relative abundance levels revealed three trans-acting genetic loci on chromosomes (chr) 7, 13 and 17 that regulate distinct classes of mitochondrial proteins as well as cardiac hypertrophy. DAVID enrichment analyses of genes regulated by each of the loci revealed that the chr13 locus was highly enriched for complex-I proteins (24 proteins, P=2.2E-61), the chr17 locus for mitochondrial ribonucleoprotein complex (17 proteins, P=3.1E-25) and the chr7 locus for ubiquinone biosynthesis (3 proteins, P=6.9E-05). Follow-up high resolution regional mapping identified NDUFS4, LRPPRC and COQ7 as the candidate genes for chr13, chr17 and chr7 loci, respectively, and both experimental and statistical analyses supported their causal roles. Furthermore, a large cohort of Diversity Outbred mice was used to corroborate Lrpprc gene as a driver of mitochondrial DNA (mtDNA)-encoded gene regulation, and to show that the chr17 locus is specific to heart. Variations in all three loci were associated with heart mass in at least one of two independent heart stress models, namely, isoproterenol-induced heart failure and diet-induced obesity. These findings suggest that common variations in certain mitochondrial proteins can act in trans to influence tissue-specific mitochondrial functions and contribute to heart hypertrophy, elucidating mechanisms that may underlie genetic susceptibility to heart failure in human populations.

La laguna de Yahuarcocha y su cuenca han sufrido una serie de transformaciones a lo largo del tiempo. Gran parte del área en torno a la laguna ha sido y es usada para agricultura. En el año 1972, se construyó una pista automovilística alrededor de laguna, lo que generó una zona urbana destinada básicamente a turismo y hoteles. Aparte de la influencia antrópica, la zona, históricamente, ha sufrido épocas de lluvia y sequías anómalas que han impactado en la dinámica de la laguna. En los años 1977-78, se realizaron los primeros estudios limnológicos, que encontraron clorofíceas, euglenofíceas y diatomeas, y escasa cantidad de cianobacterias. En aquellos estudios se evidenciaron floraciones de Euglena sanguínea, que tornaron el agua roja en épocas de sequía. A partir del 2014, los estudios realizados en la laguna han reportado floraciones de la cianobacteria Raphydiosis raciborskii. En esta contribución presentamos resultados de los muestreos realizados en los años 2020 y 2021, en época seca y de lluvia, en la laguna de Yahuarcocha. Encontramos una fuerte floración de Planktothrix agardhii (Gomont) Anagnostidis & Komárek (1988), entre el 75% y el 90%; es una cianobacteria, potencialmente tóxica, que no ha sido reportada antes en la laguna, cuya presencia confirmamos a través de análisis de metagenómica en el 2021. Esta cianobacteria podría afectar a la población circundante y turística.

In this study various samples were fabricated by increasing the amount of CNT from 0% to 5%. The bulk mechanical properties of the samples were measured using DMA. Alternatively, the local mechanical properties were assessed using nanoindentation technique. There is a clear trend that the behavior of the material is dependent of carbon fillers before, during and after percolation threshold. The bulk mechanical properties were reduced after the percolation threshold due to CNT agglomeration. Then the samples were exposed to acid solution for one week and one month. Regardless the amount of CNT in the matrix, there is always a gradient of properties from the skin to the core of the sample. There is a net reduction of in physical properties. However, the level of degradation was a dependent of the amount of CNT in the host polymer. At higher concentration the CNTs behave as a barrier. However due to the formation of porosity around the CNT agglomerates, the acid diffusion encounters preferential path ways. . Both techniques lead to the same observation..

Heterogeneity in the occurrence, amount, and distribution of precipitation in mountainous areas is relevant for water resources and stresses the need for high-altitude observations and high-resolution modeling over complex terrain. However, the harsh weather conditions and the complex terrain associated with these environments hinder a continuous monitorization and pose challenges for regional climate models.In this work, data from 37 stations located in the Sierra de Guadarrama and nearly lowlands, in Central Spain, and with altitudes ranging from 600 to 2200 m.a.s.l. have been studied. A few of the highest altitude sites belong to GuMNet facility (https://www.ucm.es/gumnet) and the rest to the Spanish Meteorological Agency (AEMET; https://www.aemet.es). These data have been compared to ERA5 reanalysis (https://confluence.ecmwf.int/display/CKB/ERA5) and to three different resolution (9, 3, and 1 km) outputs of a simulation of the regional climate model WRF (https://www.mmm.ucar.edu/WRF) during the period from 1990-2019. The comparison of the different data sources aims at characterizing the precipitation distribution over the area, assessing the goodness of ERA5, and the potential added value of the increasing resolution of WRF simulation in reproducing the observations.Results show that the increase in WRF resolution from 9 to 3 km always produces a better representation of precipitation, whereas the step from 3 to 1 km shows a significant improvement at the highest altitudes, but an overestimation of precipitation at low plain areas. The lack of added value in the simulation at the highest resolution is discussed in relation to the parameterization of cumulus precipitation. Also, an altitudinal gradient of precipitation is observed and can be traced to large-scale precipitation.

Projections from Earth system models (ESMs) are essential to allow for targeted mitigation and adaptation strategies for climate change. ESMs are state-of-the-art numerical climate models used to simulate the vastly complex Earth system including physical, chemical, and biological processes in the atmosphere, ocean, and on land. Progress in climate science and an increase in available computing resources over the last decades has led to a massive increase in the complexity of ESMs and the amount of data and insight they provide. For this reason, innovative tools for a frequent and comprehensive model evaluation are required more than ever. One of these tools is the Earth System Model Evaluation Tool (ESMValTool), an open-source community diagnostic and performance metrics tool.Originally designed to assess output from ESMs participating in the Coupled Model Intercomparison Project (CMIP), ESMValTool expects input data to be formatted according to the CMOR (Climate Model Output Rewriter) standard. While this CMORization of model output is a quasi-standard for large model intercomparison projects like CMIP, this complicates the application of ESMValTool to non-CMOR-compliant data, like native climate model output (i.e., operational output produced by running the climate model through the standard workflow of the corresponding modeling institute). Recently, ESMValCore, the framework underpinning ESMValTool, has been extended to enable reading and processing native climate model output. This is implemented via a CMOR-like reformatting of the input data during runtime. For models using unstructured grids, data can optionally be regridded to a regular latitude-longitude grid to facilitate comparisons with other data sets. The new features are described in more detail in Schlund et al., 2022 (https://doi.org/10.5194/gmd-2022-205) and in the software documentation available at https://docs.esmvaltool.org/en/latest/input.html#datasets-in-native-format.This extension opens up the large collection of diagnostics provided by ESMValTool for the five currently supported ESMs CESM2, EC-Earth3, EMAC, ICON, and IPSL-CM6. Applications include assessing the models’ performance against observations, reanalyses, or other simulations; the evaluation of new model setups against predecessor versions; the CMORization of native model data for contributions to model intercomparison projects; and monitoring of running climate model simulations. Support for other climate models can be easily added. ESMValTool is an open-source community-developed tool and contributions from other groups are very welcome.

Systems genetics has begun to tackle the complexity of insulin resistance by capitalising on computational advances to study high-diversity populations. “Diversity Outbred in Australia (DOz)” is a population of genetically unique mice with profound metabolic heterogeneity. We leveraged this variance to explore skeletal muscle’s contribution to whole-body insulin action through metabolic phenotyping and skeletal muscle proteomics of 215 DOz mice. Linear modelling identified 553 proteins that associated with whole-body insulin sensitivity (Matsuda Index) including regulators of endocytosis and muscle proteostasis. To enrich for causality, we refined this network by focussing on negatively associated, genetically regulated proteins, resulting in a 76-protein fingerprint of insulin resistance. We sought to perturb this network and restore insulin action with small molecules by integrating the Broad Institute Connectivity Map platform andin vitroassays of insulin action using the Prestwick chemical library. These complimentary approaches identified the antibiotic thiostrepton as an insulin resistance reversal agent. Subsequent validation inex vivoinsulin resistant mouse muscle, and palmitate induced insulin resistant myotubes demonstrated potent insulin action restoration, potentially via up-regulation of glycolysis. This work demonstrates the value of a drug-centric framework to validate systems level analysis by identifying potential therapeutics for insulin resistance.

The continuous, varved and absolutely dated sedimentary record of Lake Montcortès (Iberian Pyrenees) has provided evidence for a distinct and characteristic 20th century (1980s) increase in Cannabis pollen (20C) that persists today. This event was coeval with the geographical shift of the hemp production center in the Iberian Peninsula from east to northeast (where Lake Montcortès lies), which was accompanied by a significant production increase. This increasing trend was fostered by the renewed interest of the paper industry in hemp and was promoted by the onset of European Union subsidies to hemp cultivation. Illegal cannabis crops could have also contributed to the Cannabis pollen increase, but sound evidence is still lacking. These preliminary conclusions should be reinforced by increasing the resolution of the current palynological record and modeling the dispersal of Cannabis pollen around the Montcortès region. More similar high-resolution records are needed to verify the geographical extent of the 20C event. Additionally, Lake Montcortès varved sediments are proposed as a suitable candidate to characterize the onset of the ¿Anthropocene¿ epoch (mid-20th century), as currently defined by the Anthropocene Working Group., This work has been funded by the Ministry of Economy and Competitiveness, projects CGL 2012-3665 and CGL 2017-85682-R. The comments by two anonymous reviewers are greatly acknowledged., Highlights Abstract Graphical abstract Keywords 1. Introduction 2. Material and methods 3. Results 4. Discussion 5. Conclusions and future prospects CRediT authorship contribution statement Declaration of competing interest Acknowledgments Data availability References

SummaryInsulin resistance (IR) is a complex metabolic disorder that underlies several human diseases, including type 2 diabetes and cardiovascular disease. Despite extensive research, the precise mechanisms underlying IR development remain poorly understood. Here, we provide new insights into the mechanistic connections between cellular alterations associated with IR, including increased ceramides, deficiency of coenzyme Q (CoQ), mitochondrial dysfunction, and oxidative stress. We demonstrate that elevated levels of ceramide in the mitochondria of skeletal muscle cells results in CoQ depletion and loss of mitochondrial respiratory chain components, leading to mitochondrial dysfunction and IR. Further, decreasing mitochondrial ceramide levels in vitro and in animal models increased CoQ levels and was protective against IR. CoQ supplementation also rescued ceramide-associated IR. Examination of the mitochondrial proteome from human muscle biopsies revealed a strong correlation between the respirasome system and mitochondrial ceramide as key determinants of insulin sensitivity. Our findings highlight the mitochondrial Ceramide-CoQ-respiratory chain nexus as a potential foundation of an IR pathway that may also play a critical role in other conditions associated with ceramide accumulation and mitochondrial dysfunction, such as heart failure, cancer, and aging. These insights may have important clinical implications for the development of novel therapeutic strategies for the treatment of IR and related metabolic disorders.

New SARS-CoV-2 variants can potentially disrupt ongoing public health measures and vaccine efforts. Still, little is known regarding how frequently new viral variants emerge and under what circumstances.

Studies of language evolution in the lab have used the iterated learning paradigm to show how linguistic structure emerges through cultural transmission—repeated cycles of learning and use across generations of speakers (see Kirby, 2017). However, agent-based simulations (e.g., Navarro et al., 2018) suggest that prior biases crucially impact the outcome of cultural transmission. Here, we explored this notion through an iterated learning study of English-French bilingual adults (mostly sequential bilinguals dominant in English). Each participant learned two unstructured artificial languages in a counterbalanced fashion, one resembling English, another resembling French at the phono-orthographic level. The output of each participant was passed down to the next participant, forming diffusion chains of ten generations per language. We hypothesized that artificial languages would become easier to learn and exhibit greater structure when they were aligned with participants’ bilingual experience (i.e., English languages being easier to learn overall), or as a function of practice (i.e., languages learned second being easier to learn overall). Instead, we found that English-like languages became more structured over generations, but only when they were learned first. In contrast, French-like languages became more structured regardless of the order of learning, suggesting the presence of an asymmetric switch cost during artificial language learning. Moreover, individual differences in language usage modulated the amount of structure produced by the participants. Overall, these data suggest that bilingual experience impacts how novel languages are learned at an individual level, which can then scale up to cultural transmission of novel language at a group level.

Producción Científica, Identifying potentially life-threatening diseases is a key challenge for emergency medical services. This study aims at examining the role of different prehospital biomarkers from point-of-care testing to derive and validate a score to detect 2-day in-hospital mortality. We conducted a prospective, observational, prehospital, ongoing, and derivation—validation study in three Spanish provinces, in adults evacuated by ambulance and admitted to the emergency department. A total of 23 ambulance-based biomarkers were collected from each patient. A biomarker score based on logistic regression was fitted to predict 2-day mortality from an optimum subset of variables from prehospital blood analysis, obtained through an automated feature selection stage. 2806 cases were analyzed, with a median age of 68 (interquartile range 51–81), 42.3% of women, and a 2-day mortality rate of 5.5% (154 non-survivors). The blood biomarker score was constituted by the partial pressure of carbon dioxide, lactate, and creatinine. The score fitted with logistic regression using these biomarkers reached a high performance to predict 2-day mortality, with an AUC of 0.933 (95% CI 0.841–0.973). The following risk levels for 2-day mortality were identified from the score: low risk (score, Junta de Castilla y León (Gerencia Regional de Salud - grant number GRS 1903/A/19 and GRS 2131/A/20), Ministerio de Ciencia e Innovación/Agencia Estatal de Investigación/10.13039/501100011033/’, ERDF A way of making Europe, and Next GenerationEU/PRTR (under projects PID2020-115468RB-I00 and PDC2021-120775-I00), CIBER -Consorcio Centro de Investigación Biomédica en Red (Instituto de Salud Carlos III) (CB19/01/00012), Publicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCLE

Summary Culturally-responsive health promotion initiatives are important to the creation of health equity for Indigenous and minority populations and these initiatives are complex and time-intensive to establish. The knowledge and resources of cultural experts are often pivotal in programs, yet there is minimal research on effective collaborations. The KāHOLO Project demonstrated strong success in the management of uncontrolled hypertension in the high-risk Indigenous population through a 6-month program based on the Hawaiian cultural dance of hula. This program was developed utilizing a community-based participatory research approach and implemented by cultural experts. To better understand the effectiveness of the research endeavor and program, six experienced hula experts and educators who delivered the community-based program were interviewed. As skilled and trusted cultural experts they set a safe supportive learning environment that promoted health and cultural goals. They articulated it was important that the program maintained cultural priorities and integrity. Through the methodical establishment of mutual respect, cooperation on research protocols and requirements was achieved. The development of cultural experts as health allies offers important inroads to the inclusion of minority and Indigenous cultures in health programming.

Funder: Wellcome-MRC, Institute of Metabolic Science, Metabolic Research Laboratories, Imaging Core, Insulin-induced GLUT4 translocation to the plasma membrane in muscle and adipocytes is crucial for whole-body glucose homeostasis. Currently, GLUT4 trafficking assays rely on overexpression of tagged GLUT4. Here we describe a high-content imaging platform for studying endogenous GLUT4 translocation in intact adipocytes. This method enables high fidelity analysis of GLUT4 responses to specific perturbations, multiplexing of other trafficking proteins and other features including lipid droplet morphology. Using this multiplexed approach we showed that Vps45 and Rab14 are selective regulators of GLUT4, but Trarg1, Stx6, Stx16, Tbc1d4 and Rab10 knockdown affected both GLUT4 and TfR translocation. Thus, GLUT4 and TfR translocation machinery likely have some overlap upon insulin-stimulation. In addition, we identified Kif13A, a Rab10 binding molecular motor, as a novel regulator of GLUT4 traffic. Finally, comparison of endogenous to overexpressed GLUT4 highlights that the endogenous GLUT4 methodology has an enhanced sensitivity to genetic perturbations and emphasises the advantage of studying endogenous protein trafficking for drug discovery and genetic analysis of insulin action in relevant cell types.

Pending a reformulation of the syllabus in the Autonomous Community of the Basque Country, and starting from the difficulties around speaking and writing about art, we will study the so-called Artistic Competence in the current educational plan and the text where it’s written, “Heziberri 2020” (2016). The main objective will be to establish a distinction between the ways of generating meaning in art and in communication-systems, deepening in the consequences that saying and writing one thing or the other have on the learning of art. For this purpose, and based on the inadequate analogy between communication-systems and art addressed by artist and professor of philosophy Aitor Izagirre (2008) we will merge the conclusions of two recent studies, declaring a complete distinction between art and the systems of language. Ultimately, we will address the need for a new educational project that will try to draw art out of the context of communicative practices, with the aim of encouraging the academic community and the producers of the field of art to revise the view proposed by the Department of Education, imagining new lexicons for writing.; Euskal Autonomia Erkidegoaren Hezkuntza Sailak laster aurkeztuko duen curriculumaren birformulazio eta eguneratzeak artearen hezkuntzari buruz zer esateko duen ikustearen zain, eta artearen jakintzaren inguruan idatzi eta esateak berezkoa duen zailtasunetik abiatuta, egun indarrean dagoen Heziberri 2020 berriztapen planak (2016) proposatzen duen Arterako konpetentzia definitzen duen testua aztertuko dugu. Helburua artearen praktikan eta komunikazio-sistema batean esanahia eraikitzeko prozesuen bereizketa egitea izango da, arteari buruz zer esateak eta nola idazteak artearen ezagutzan dituen ondorioetan sakonduz. Horretarako, Aitor Izagirre artista eta filosofia irakaslearen Artea eta Hizkuntza: analogia desegokia artikuluak (2008) proposatzen duen esana eta esanahiaren arteko dikotomia arestian egindako bi ikerketen ondorioekin osatuko dugu, artearen jakintzaren eta hizkuntza-sistemen erabateko bereizketa aldarrikatuz. Finean, artea praktika komunikatiboaren esparrutik ateratzen saiatuko den hezkuntza-proiektu berri baten beharra azalduko dugu, komunitate akademikoari eta artearen esparruko ekoizleei EAEko Hezkuntza Sailak orain arte proposatu duen ikuspegiaren berrikusketa sustatzeko asmoz, idazkerarako lexiko berriak imajinatuz.

El presente artículo pretende evidenciar los precedentes del ocaso de la prostitución legalizada en la Castilla del primer cuarto del Seiscientos. Para ello se contextualizará, de un lado, la doble moralidad de la sociedad de la Edad Moderna al censurar con mayor rigor, en el terreno sexual y de la honra, las conductas de la mujer y disculpar las del hombre y legitimar, al mismo tiempo, la prostitución a través de políticas desplegadas desde la Baja Edad Media por la propia Monarquía Hispánica. De otra parte, analizaremos las intensas campañas jesuíticas de predicación y actuación contra los burdeles, a tenor de la documentación rastreada en el Archivo Histórico Nacional para el caso de Antequera en las primeras décadas del siglo XVII ejemplo claro, junto con otros enclaves castellanos, de las causas que precipitaron el final de la prostitución autorizada y controlada por la Corona en 1623, criminalizando desde entonces a la mujer pública.