La segunda vida de Rafiq Hariri

Las movilizaciones que siguieron al atentado que costó la vida al ex- Primer Ministro libanés Rafiq Hariri el 14 de febrero de 2005 se vertebraron alrededor de la exaltación del político que había dominado la escena oficial nacional de la posguerra, dentro de un ambiente de fascinación iconográfica y de elogio fúnebre llevados hasta la exageración, en abierto contraste con las críticas de las que tanto persona como legado habían sido objeto hasta el momento de su asesinato. La máquina mediática y el complejo económico Hariri favorecieron el proceso de santificación del multimillonario de Saida y de su entorno, exonerándolo de sus responsabilidades a lo largo de diez años al frente del poder ejecutivo y rescribiendo así la historia reciente de Líbano para presentarlo como figura central en la lucha por la salvación del país y, con su sacrificio, padre de una segunda independencia. Aquí vamos a examinar en primer lugar las diferentes legitimaciones que, movilizadas en el proceso de glorificación, constituyeron un complejo conglomerado de adulación que confundía al mismo tiempo y a diferentes niveles las tres fuentes de legitimidad descritas por Max Weber. Después, se analizará el papel de los distintos actores políticos y sociales dentro del movimiento, para establecer con qué objetivo participó cada uno de ellos y para preguntarnos hasta qué punto conseguirá esta construcción mítica solidificarse dentro de la historia y de la memoria nacionalesThe mobilizations that followed the attack that killed the former Lebanese Prime minister Rafiq Hariri on February, 14th of 2005 were organized around the exaltation of the politician who had dominated the national official scene of the postwar period, within an iconographical fascination atmosphere and funeral praise until the exaggeration, in opened contrast with the critics that his figure and legacy had been objet until the moment of their murder. The mediatic machine and the Hariri’s economic group favored the process of sanctification of Saida’s multimillionaire and its surroundings, exonerating him from their responsibilities throughout ten years at the front of the executive authority and writing again the recent history of Lebanon to present him as central figure in the fight of the country salvation and, with their sacrifice, father of the second independence. Here we will examine in the first place the different legitimations that, mobilized in the glorification process, constituted a conglomerated complex of flattery that confused at the same time and at different levels the three sources of legitimacy described by Max Weber. Later, the rol of the different political and social actors will be analyzed within the movement, to establish whereupon objective each one participated and to ask to what extent this mythical construction will be able to solidify itself within national history and memor

Methodological resources for the acquisition of competences and the students’ insertion with regard to the reality of homeless people

El proyecto de innovación docente presentado pretende concienciar y sensibilizar a los estudiantes de la realidad de las Personas Sin Hogar (PSH), para adquirir valores de respeto, solidaridad y empatía por este sector de la sociedad, a través de actividades académicamente dirigidas (ADD), empleando una metodología activa y participativa centrada en el trabajo grupal y cooperativo que facilite el logro de competencias propias de su titulación. Para ello, se planificaron una serie de actividades que favorecieron la coordinación horizontal y vertical de las materias participantes en las Titulaciones de Grado en Educación Infantil y de Grado en Educación Primaria del Centro de Magisterio “Sagrado Corazón”. De esta forma, los resultados implican la conexión y continuidad entre las materias participantes. Por último, las conclusiones muestran que los estudiantes universitarios interiorizan los valores necesarios para la transferencia de aprendizajes adquiridos, a través de la experiencia vivencial con la realidad de las PSH, la cual permite una mirada conjunta de la inclusión y la invisibilidad social, empleando un enfoque participativo donde las opiniones e inquietudes de ambos colectivos se tengan en cuenta. Para ello, es preciso no poner barreras excluyentes a la educación del estudiante como futuro docente.The present innovative teaching proyect aims at raising awareness and moving students about the reality of homeless people, in order to acquire values of respect, solidarity and empathy for this society sector, through curricular activities, implementing an active and participatory methodology based on group and cooperative work which promotes the attainment of competences of their own degree. For this purpose, a set of activities that favoured horizontal and vertical coordination of the subjects involved in the Degrees in Early Childhood Education and Primary Education of the “Sagrado Corazón” Teacher Training School were planned. Thus, the outcomes involve the connection and the continuity between the subjects concerned. Finally, the findings show that university students internalize the values necessary for the transfer of learning acquired, through the lived experience with the reality of homelessness, which allows for an overall perspective of inclusion and social invisibility, by applying a participatory approach where views and concerns of both sides are given due consideration. This requires the removal of exclusive barriers to the education of the student as a future teacher

Enfermedades psiquiátricas y trabajo. Revisión bibliográfica y jurisprudencial (Trastornos esquizofrénicos, trastorno bipolar y trastornos ansioso-depresivos)

Las enfermedades psiquiátricas en su conjunto y, algunas de ellas de forma específica, constituyen un problema de salud pública en todos los países y conllevan un coste económico asociado, tanto directo como indirecto. Pero además, cuando la persona enferma ejerce su derecho al trabajo ello comporta, en ocasiones, más allá de su diagnóstico y su tratamiento, la necesidad de tomar unas acciones en las empresas, limitantes adaptativas o restrictivas, para el trabajador afectado y la adopción de medidas socio-laborales con repercusión posterior administrativa y jurídica. Se revisarán en este trabajo las publicaciones médicas recogidas en la base de datos de referencia (Pub-Med) relativa a estas patologías, su diferenciación en cuanto a los aspectos clínico asistenciales y su comparativa con los socio-laborales. De igual forma se realiza en este trabajo una revisión del impacto de estas patologías en la base de datos jurídica (Westlaw Insignis) y su diferenciación según cada patología y área del derecho correspondiente. Sirvan los resultados para, a través del conocimiento actual de la situación, basada en estos datos, elaborar posibles estrategias preventivas de futuro ante conflictos médico legales y de nuevos enfoques más coordinados entre todos los agentes implicados.Psychiatric disorders as a whole and some of them in a specific way constitute a public health problem in all countries and entail an economic cost associated, both directly and indirectly. In addition, some issues are to be considered when the sick person exercises his right to work, beyond diagnosis and treatment of his/her disease. Companies need to take some actions whether adaptive or restrictive for the affected employee, and the adoption of socio-labor measures which will have administrative and legal impact. The medical publications listed in the reference database (Pub-Med) concerning these pathologies will be reviewed in this article with emphasis in those clinical aspects that correlate health care with socio-labor implications. Paralelly, this work reviews the impact of these diseases in the legal databases (Westlaw Insignis) and their differentiation according to each disorder and its corresponding area of the law.The conclusions of this work, through the current knowledge of the situation, will serve to develop possible preventive strategies to address future medico-legal conflicts as well as to develop more coordinated approaches among all the stakeholders

Consumo de alcohol y riesgo de accidentes de tráfico en España. Aspectos preventivos

Introducción: Las bebidas alcohólicas se consumen ampliamente en todo el mundo y también en España. Aunque la mayoría de la población adulta tiene un patrón de consumo de bajo riesgo, existen personas que presentan patrones lesivos de consumo que van desde el bebedor diario de gran cantidad, al consumo de riesgo ocasional/social. Esta situación genera problemas de seguridad vial en casi todos los países asociados a cambios en el rendimiento psicomotor del consumidor con posterior repercusión en riesgo de accidentes. Método: Para realizar esta revisión se han consultado la base de datos de la Organización Mundial de la Salud: World Health Organization. Global Information System on Alcohol and Health (GISAH) y los resultados del estudio EDADES. Se ha hecho una búsqueda bibliográfica en PubMed y otras bases de datos de referencia (Latindex, Scopus, Índice Bibliográfico Español en Ciencias de la Salud –IBECS sobre los términos de búsqueda: alcohol consumption and road traffic injuries, seleccionándose a criterio de los autores aquellos trabajos considerados más significativos). Conclusiones: Se trata de un complejo problema con repercusión individual en los afectados y trascendencia socioeconómica y en la que destaca la especial implicación en sus efectos de las personas más jóvenes, lo que requiere de un esfuerzo preventivo conjunto sanitario, social y de las Administraciones Públicas para obtener resultados en plazos lo más breves posible y reducir la mortalidad, morbilidad y limitaciones resultantes ocasionadas por la conducción bajo los efectos de las bebidas alcohólicas, con frecuencia asociados al consumo de otro tipo de drogas y aceptado cada vez más por la sociedad en actividades de ocio.Introduction: Alcoholic beverages are widely consumed around the world and also in Spain. Although most of the adult population has a pattern of low-risk drinking, there are people with harmful drinking patterns ranging from daily drinker wealth, consumption casual / social risk. This creates traffic problems in almost all countries associated with changes in psychomotor performance consumer with subsequent impact on accident risk. Methods: To perform this review we have consulted the database of the World Health Organization: World Health Organization. Global Information System on Alcohol and Health ( GISAH ) and the results of the EDADES study. It has become a literature search in PubMed and other databases of reference (Latindex Scopus Spanish Bibliographic Index of Health Sciences -IBECS about search terms: Alcohol Consumption and road traffic injuries, and have been selected by the authors tose works considered more relevants. Conclusions: This is a complex issue with individual impact on those affected and socio-economic importance and which highlights the special involvement in the effects of younger people, which requires a preventive effort overall health, social and government for results in shorter periods and may reduce mortality, morbidity and resulting limitations caused by driving under the influence of alcoholic beverages, often associated with the consumption of other drugs and increasingly accepted by society in leisure activities

Intratumoral injection of dendritic cells engineered to secrete interleukin-12 by recombinant adenovirus in patients with metastatic gastrointestinal carcinomas.

PURPOSE: To evaluate the feasibility and safety of intratumoral injection of autologous dendritic cells (DCs) transfected with an adenovirus encoding interleukin-12 genes (AFIL-12) for patients with metastatic gastrointestinal carcinomas. Secondarily, we have evaluated biologic effects and antitumoral activity. PATIENTS AND METHODS: Seventeen patients with metastatic pancreatic (n = 3), colorectal (n = 5), or primary liver (n = 9) malignancies entered the study. DCs were generated from CD14+ monocytes from leukapheresis, cultured and transfected with AFIL-12 before administration. Doses from 10 x 10(6) to 50 x 10(6) cells were escalated in three cohorts of patients. Patients received up to three doses at 21-day intervals. RESULTS: Fifteen (88%) and 11 of 17 (65%) patients were assessable for toxicity and response, respectively. Intratumoral DC injections were mainly guided by ultrasound. Treatment was well tolerated. The most common side effects were lymphopenia, fever, and malaise. Interferon gamma and interleukin-6 serum concentrations were increased in 15 patients after each treatment, as well as peripheral blood natural killer activity in five patients. DC transfected with AFIL-12 stimulated a potent antibody response against adenoviral capsides. DC treatment induced a marked increase of infiltrating CD8+ T lymphocytes in three of 11 tumor biopsies analyzed. A partial response was observed in one patient with pancreatic carcinoma. Stable disease was observed in two patients and progression in eight patients, with two of the cases fast-progressing during treatment. CONCLUSION: Intratumoral injection of DC transfected with an adenovirus encoding interleukin-12 to patients with metastatic gastrointestinal malignancies is feasible and well tolerated. Further studies are necessary to define and increase clinical efficacy

The CARMENES search for exoplanets around M dwarfs. Wolf 1069 b: Earth-mass planet in the habitable zone of a nearby, very low-mass star

D. Kossakowski et al.We present the discovery of an Earth-mass planet (Mb sin i = 1.26 ± 0.21 M⊕) on a 15.6 d orbit of a relatively nearby (d ~ 9.6 pc) and low-mass (0.167 ± 0.011 M⊙) M5.0 V star, Wolf 1069. Sitting at a separation of 0.0672 ± 0.0014 au away from the host star puts Wolf 1069 b in the habitable zone (HZ), receiving an incident flux of S = 0.652 ± 0.029 S⊕. The planetary signal was detected using telluric-corrected radial-velocity (RV) data from the CARMENES spectrograph, amounting to a total of 262 spectroscopic observations covering almost four years. There are additional long-period signals in the RVs, one of which we attribute to the stellar rotation period. This is possible thanks to our photometric analysis including new, well-sampled monitoring campaigns undergone with the OSN and TJO facilities that supplement archival photometry (i.e., from MEarth and SuperWASP), and this yielded an updated rotational period range of Prot = 150–170 d, with a likely value at 169.3−3.6+3.7. The stellar activity indicators provided by the CARMENES spectra likewise demonstrate evidence for the slow rotation period, though not as accurately due to possible factors such as signal aliasing or spot evolution. Our detectability limits indicate that additional planets more massive than one Earth mass with orbital periods of less than 10 days can be ruled out, suggesting that perhaps Wolf 1069 b had a violent formation history. This planet is also the sixth closest Earth-mass planet situated in the conservative HZ, after Proxima Centauri b, GJ 1061 d, Teegarden’s Star c, and GJ 1002 b and c. Despite not transiting, Wolf 1069 b is nonetheless a very promising target for future three-dimensional climate models to investigate various habitability cases as well as for sub-m s−1 RV campaigns to search for potential inner sub-Earth-mass planets in order to test planet formation theories.Part of this work was supported by the German Deutsche Forschungsgemeinschaft, DFG project number Ts 17/2–1. CARMENES is an instrument at the Centra Astronómico Hispano-Alemán (CAHA) at Calar Alto (Almería, Spain), operated jointly by the Junta de Andalucía and the Instituto de Astrofísica de Andalucía (CSIC). CARMENES was funded by the Max-Planck-Gesellschaft (MPG), the Consejo Superior de Investigaciones Científicas (CSIC), the Ministerio de Economía y Competitividad (MINECO) and the European Regional Development Fund (ERDF) through projects FICTS-2011-02, ICTS-2017-07-CAHA-4, and CAHA16-CE-3978, and the members of the CARMENES Consortium (Max-Planck-Institut für Astronomie, Instituto de Astrofísica de Andalucía, Landessternwarte Königstuhl, Institut de Ciències de l’Espai, Institut für Astrophysik Göttingen, Universidad Complutense de Madrid, Thüringer Landessternwarte Tautenburg, Instituto de Astrofísica de Canarias, Hamburger Sternwarte, Centro de Astrobiología and Centro Astronómico Hispano-Alemán), with additional contributions by the MINECO, the Deutsche Forschungsgemeinschaft through the Major Research Instrumentation Programme and Research Unit FOR2544 “Blue Planets around Red Stars”, the Klaus Tschira Stiftung, the states of Baden-Württemberg and Niedersachsen, and by the Junta de Andalucía. We acknowledge financial support from the Agencia Estatal de Investigación of the Ministerio de Ciencia e Innovación (AEI/10.13039/501100011033) and the ERDF “A way of making Europe” through projects PID2019-109522GB-C5[1:4], PID2019-107061GB-C64, and PID2019-110689RB-100, and the Centre of Excellence “Severo Ochoa” and “María de Maeztu” awards to the Instituto de Astrofísica de Canarias (SEV-2015-0548), Instituto de Astrofísica de Andalucía (SEV-2017-0709), and Centro de Astrobiología (MDM-2017-0737); the European Research Council under the Horizon 2020 Framework Program (ERC Advanced Grant Origins 832428 and under Marie Skłodowska-Curie grant 895525); the Generalitat de Catalunya/CERCA programme; the DFG through the priority program SPP 1992 “Exploring the Diversity of Extrasolar Planets (JE 701/5-1)” and the Research Unit FOR 2544 “Blue Planets around Red Stars” (KU 3625/2-1); the Bulgarian National Science Fund through program “VIHREN-2021” (KP-06-DV/5); the SNSF under grant P2BEP2_195285; the National Science Foundation under award No. 1753373, and by a Clare Boothe Luce Professorship.Peer reviewe

The CARMENES search for exoplanets around M dwarfs Guaranteed time observations Data Release 1 (2016-2020)

I. Ribas et al.[Context] The CARMENES instrument, installed at the 3.5 m telescope of the Calar Alto Observatory in Almería, Spain, was conceived to deliver high-accuracy radial velocity (RV) measurements with long-term stability to search for temperate rocky planets around a sample of nearby cool stars. Moreover, the broad wavelength coverage was designed to provide a range of stellar activity indicators to assess the nature of potential RV signals and to provide valuable spectral information to help characterise the stellar targets.[Aims] We describe the CARMENES guaranteed time observations (GTO), spanning from 2016 to 2020, during which 19 633 spectra for a sample of 362 targets were collected. We present the CARMENES Data Release 1 (DR1), which makes public all observations obtained during the GTO of the CARMENES survey.[Methods] The CARMENES survey target selection was aimed at minimising biases, and about 70% of all known M dwarfs within 10 pc and accessible from Calar Alto were included. The data were pipeline-processed, and high-level data products, including 18 642 precise RVs for 345 targets, were derived. Time series data of spectroscopic activity indicators were also obtained.[Results] We discuss the characteristics of the CARMENES data, the statistical properties of the stellar sample, and the spectroscopic measurements. We show examples of the use of CARMENES data and provide a contextual view of the exoplanet population revealed by the survey, including 33 new planets, 17 re-analysed planets, and 26 confirmed planets from transiting candidate follow-up. A subsample of 238 targets was used to derive updated planet occurrence rates, yielding an overall average of 1.44 ± 0.20 planets with 1 M⊕ < Mpl sin i < 1000 M⊕ and 1 day < Porb < 1000 days per star, and indicating that nearly every M dwarf hosts at least one planet. All the DR1 raw data, pipeline-processed data, and high-level data products are publicly available online.[Conclusions] CARMENES data have proven very useful for identifying and measuring planetary companions. They are also suitable for a variety of additional applications, such as the determination of stellar fundamental and atmospheric properties, the characterisation of stellar activity, and the study of exoplanet atmospheres.CARMENES is an instrument at the Centro Astronómico Hispano en Andalucía (CAHA) at Calar Alto (Almería, Spain), operated jointly by the Junta de Andalucía and the Instituto de Astrofísica de Andalucía (CSIC). CARMENES was funded by the Max-Planck-Gesellschaft (MPG), the Consejo Superior de Investigaciones Científicas (CSIC), the Ministerio de Economía y Competitividad (MINECO) and the European Regional Development Fund (ERDF) through projects FICTS-2011-02, ICTS-2017-07-CAHA-4, and CAHA16-CE-3978, and the members of the CARMENES Consortium (Max-Planck-Institut für Astronomie, Instituto de Astrofísica de Andalucía, Landessternwarte Königstuhl, Institut de Ciències de l’Espai, Institut für Astrophysik Göttingen, Universidad Complutense de Madrid, Thüringer Landessternwarte Tautenburg, Instituto de Astrofísica de Canarias, Hamburger Sternwarte, Centro de Astrobiología and Centro Astronómico Hispano-Alemán), with additional contributions by the MINECO, the Deutsche Forschungsgemeinschaft (DFG) through the Major Research Instrumentation Programme and Research Unit FOR2544 “Blue Planets around Red Stars”, the Klaus Tschira Stiftung, the states of Baden-Württemberg and Niedersachsen, and by the Junta de Andalucía. We acknowledge financial support from the Spanish Agencia Estatal de Investigación of the Ministerio de Ciencia e Innovación (AEI-MCIN) and the ERDF “A way of making Europe” through projects PID2020-117493GB-I00, PID2019-109522GB-C5[1:4], PID2019-110689RB-I00, PID2019-107061GB-C61, PID2019-107061GB-C64, PGC2018-098153-B-C33, PID2021-125627OB-C31/AEI/10.13039/501100011033, and the Centre of Excellence “Severo Ochoa” and “María de Maeztu” awards to the Institut de Ciències de l’Espai (CEX2020-001058-M), Instituto de Astrofísica de Canarias (CEX2019-000920-S), Instituto de Astrofísica de Andalucía (SEV-2017-0709), and Centro de Astrobiología (MDM-2017-0737). We also benefited from additional funding from: the Secretaria d’Universitats i Recerca del Departament d’Empresa i Coneixement de la Generalitat de Catalunya and the Agència de Gestió d’Ajuts Universitaris i de Recerca of the Generalitat de Catalunya, with additional funding from the European FEDER/ERDF funds, and from the Generalitat de Catalunya/CERCA programme; the DFG through the Major Research Instrumentation Programme and Research Unit FOR2544 “Blue Planets around Red Stars” (RE 2694/8-1); the University of La Laguna through the Margarita Salas Fellowship from the Spanish Ministerio de Universidades ref. UNI/551/2021-May-26, and under the EU Next Generation funds; the Gobierno de Canarias through projects ProID2021010128 and ProID2020010129; the Spanish MICINN under Ramón y Cajal programme RYC-2013-14875; the “Fondi di Ricerca Scientifica d’Ateneo 2021” of the University of Rome “Tor Vergata”; and the programme “Alien Earths” supported by the National Aeronautics and Space Administration (NASA) under agreement No. 80NSSC21K0593. TPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality