The age of artificial intelligence

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C o m pa r t i r

THE AGE OF ARTIFICIAL INTELLIGENCE

Technological revolution at the service of the citizen

Healthcare cooperatives and social medicine magazine | No. 16 – April 2024

ODONTOLOGY

Tips for good oral hygiene

LEISURE

‘The Producers’: Mel Brooks’ cult classic

COOPERATIVISM

New edition of the World Cooperative Monitor

Staff

Compartir Healthcare cooperativism magazine www.compartir.coop compartir@fundacionespriu.coop Editorial board: Dr. Ignacio Orce, Chairman of the Fundación Espriu and of Assistència Sanitària Dr. Enrique de Porres, CEO of ASISA-Lavinia Teresa Basurte, former Chairwoman of the Fundación Espriu Dr. Oriol Gras, sponsor of Fundación Espriu Dr. Carlos Zarco, General Manager and sponsor of Fundación Espriu

Publication: Factoría Prisma Diagonal 662-664 08034-Barcelona Tel. 639 213 710 www.factoriaprisma.com Director of Factoría Prisma: Angi González Vives Coordination: Laura Martos Design: Xavi Menéndez Printer: Centro Gráfico Ganboa SL Legal deposit: B-46099-2003 ISSN: 2488-6394 ISSN (Internet): 2696-3833 Fundación Espriu Av. de Josep Tarradellas, 123-127 4.ª planta 08029 Barcelona Juan Ignacio Luca de Tena, 12, 3.ª 28027 Madrid NIF: G-59117887 Tel.: 934 954 490 fundacionespriu@fundacionespriu.coop www.fundacionespriu.coop

Established in 1989, Fundación Espriu integrates the entities that follow the healthcare cooperative model created by Dr. Josep Espriu: Autogestió Sanitària, SCIAS, Lavinia and ASISA, which make up the Assistència Group and the ASISA Group.

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Summary

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HEALTH IN SPRING We talked to Dr. Silvia Pons about the increase of people with obesity and the possible solutions to this problem.

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ODONTOLOGY Dr. Teresa Vizuete tells us how to keep a good oral hygiene.

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COOPERATIVISM

IN DEPTH

DESTINATIONS

Assistència Sanitària and ASISA continue to grow in infrastructure and have added new services to their Assisport and ASISA Vida insurances.

An overview of artificial intelligence’s impact on society and its application in the medical sector.

We discover the lakes of Lombardy, one of the most natural places in Italy, scene of numerous films.

Editorial

For a more humane and efficient medicine The technological future

we predicted years ago has already arrived and is beginning to make its first inroads in society. In the last decade, artificial intelligence (AI) has transformed information and the way we relate to it. But more recently, so-called generative artificial intelligence, which is capable of learning and creating original content, is having a major impact on many aspects of daily life.

In the field of medicine, this tool can provide solutions to new healthcare challenges and respond to the need to reorganise hospital management. Moreover, in combination with revolutionary practices, such as personalised medicine or precision diagnostics, it will bring a qualitative leap in care and service offered to patients.

While some of the new systems are still a prototype with a few years of work to be done, the sector is already using technologies that undoubtedly increase the efficiency of many processes, while enhancing the human factor inherent to the medical profession, thus improving the patient experience. I invite you to discover this in the central report.

We also take the opportunity to cover some issues concerning citizens’ health. The World Atlas of Obesity alerts us of a growing trend towards a lack of healthy habits. In Spain, 35% of the population will suffer from obesity in 2035, an alarming figure that we must tackle with some urgency. In these pages you can also read some advice related to oral health, physical activity and even how to act in some emergency cases.

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LEISURE

The musical The Producers, directed by Àngel Llàcer and Manu Guix, comes to Madrid after months of success in Barcelona.

CORRECTION About the right to be forgotten for cancer patients from the report ‘A Fondo’ [page 20 of Compartir number 15]: The Spanish government approved the relevant legislation to guarantee this right on June 23rd, 2023.

Our institutions, ASISA and Assistència Sanitària, have launched numerous new developments over the first quarter of the year, ranging from the expansion of certain services to improvements to the infrastructures at centres across the country.

You can also find out about some of the new openings planned for this year.

The last pages of the magazine, as usual, contain some leisure activities that I hope they will be of your interest.

Carlos Zarco

General Manager of Fundación Espriu

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Today’s news

Almost a third of the population does not sleep the recommended minimum number of hours Ultra-processed food linked to 32 detrimental health outcomes Ultra-processed foods are defined as foods that have undergone specific industrial processing of substances and additives, which generally stimulate the appetite.

According to a study published in The BMJ, a diet rich in these foods is associated with an increased risk of up to thirty-two harmful health outcomes, including pathologies such as cancer, heart and lung disease, mental health disorders and even premature death.

As the study explains, ultra-processed foods now represent up to 58% of total daily energy intake in some rich countries and their increase in recent decades is worrying.

The findings reveal that a higher ingestion of these foods is associated with a 50% increased risk of death related to cardiovascular disease, a 48-52% increased risk of anxiety and a 12% increased risk of type 2 diabetes. In addition, it also mentions the development of sleep-related problems and depression.

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S

leep directly influences the functioning of the body, affecting metabolism, mood and the immune system in a very direct way. The World Health Organisation (WHO) defines proper rest as the quality and quantity of sleep, setting the minimum at a range of six to seven hours per day, at the same hours.

Global research has concluded that almost a third of adults do not get enough rest at night.

The study, published in the journal Sleep Health, installed a sensor in the mattresses of 67,000 participants to analyse the number of hours they slept.

As a result of the study, only

International day for:

Health (April 7) The First World Health Assembly was held in 1948 and suggested commemorating the founding of the World Health Organization (WHO).

This year’s theme was chosen to defend people’s rights, everywhere, to have access to quality health services, education and information, as well as to drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, and non-discrimination.

To address these kinds of challenges, the theme of World Health Day 2024 is “My health, my right”.

Inspiring quotes

“Take care of your body.

It’s the only place you have to live” Jim Rohn, entrepreneur and writer

While we sleep, neurons restore and repair and decreases oxidative stress in the brain.

15% of the participants slept the prescribed hours a minimum of five days per week.

Thirty percent of the adults showed an average sleep duration outside the recommended range of seven to nine hours. And participants who used to have this average duration, however, also fell outside this range 40% of nights, so irregular sleep is prevalent.

Among the results we also found that women had significantly longer sleep durations than male participants, and middle-aged participants had shorter sleep duration than younger or older participants.

The first migraine-relieving drug arrives Migraines are a type of headache characterised by symptoms such as nausea, vomiting or sensitivity to light and sound. It is suffered by more than one billion people in the world, 1.4 million in Spain. Eighty percent of patients are women between 20 and 40 years of age. Migraines are a source of neurological disability, according to the Spanish Society of Neurology (SEN).

One of the main problems of this pathology is the lack of specific drugs

for its prevention or to alleviate the symptoms.

This situation seems to be changing, thanks to the launch of Vydura, the first specific treatment for this condition to be marketed in Spain. It is a pill that attacks the focus of the pain and acts as a protector, preventing the recurrence of symptoms.

The medication acts on the receptors of a specific protein found in the blood of migraine sufferers, reducing vasodilation and neurogenetic inflammation.

Patients begin to feel the effects within two hours of taking it and relief is sustained for up to 48 hours after taking it.

It is manufactured in the Pfizer laboratory and has been commercialised in more than 40 countries.

Spain drives 90% of clinical trials for rare diseases According to data from the Spanish Clinical Studies Register (REEC), in 2023 there will already be 182 investigations into new medicines for the treatment of rare diseases, a figure that has increased almost ninefold in the last eight years and which represents 90% of the clinical studies conducted in Europe for this type of disease.

For its part, the European Medicines Agency states in its latest report that of the 34 innovative medicines authorised in 2023 (with a new active ingredient), 35% are intended to treat these diseases. Moreover, in recent years, the percentage of early-stage research has also increased, allowing patients access to new drugs under investigation.

While it is true that Spain has become a world leader in clinical studies, access to medicines related to rare diseases - which affect almost three million people in this country - is often more limited or less safe. In fact, according to the Spanish Society of Neurology, 65% of rare diseases are severe and disabling, and in half of the cases they affect life prognosis.

Currently, it is estimated that there are more than 7,000 rare diseases of which 6,200 are known, according to Orphanet data.

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Health in spring

OBESITY:

the most stigmatised chronic disease Spain is one of the European countries with the highest prevalence of obesity: more than 60% of people are overweight. This chronic disease is a global health problem and, as corroborated by the ‘World Atlas of Obesity’ report, by 2035 more than half of the population will be overweight. by Ángela Zorrilla

S

ince 1975, obesity has tripled worldwide and it is estimated that in European countries more than 70% of adults are unhealthily overweight. This over-accumulation of fat is highly detrimental to health and one of the causes is the imbalance in energy between calories consumed and calories burned. In this regard, the World Health Organisation has been warning for

% of obese people in Spain 16% of the adult population (aged 18 and over) is obese.

Men

≥ 85

12,70 %

20,50 %

75-80

17,50 % 22,40 %

65-74

23,20 %

55-64

23,50 % 21,90 % 18,60 %

45-54

18,90 %

15,30 %

35-44

15,80 %

13,10 %

25-34

9,50 %

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Women

Age

10,30 %

4,60 %

18-24

4,70 %

1,70 %

15-17

4%

years that this situation is a consequence of a diet rich in fat and a new more sedentary lifestyle. For this reason, the great demand of researchers, medical professionals and patients is to recognise obesity as a chronic, complex and multifactorial disease. But it is also preventable and treatable.

A wake-up call

A research study carried out by the Organisation for Economic Co-operation and Development (OECD) confirms that obesity in Spain reduces life expectancy by 2.6 years and it is responsible for 9.7% of health costs. It also suggests that for every euro invested in obesity prevention in Spain, six would be gained back.

The data provided by this report is clear: in our country, 25% of men and 23% of women live with obesity.

The WHO estimates that, by 2035, one in four people worldwide will be obese, a problem that is particularly worrying among children and young people. In 2016, 41 million children under the age of five were overweight or obese, and nearly 340 million children and young people aged 5-19 were overweight or obese. According to data from the Aladdin 2019 study, 40.6% of the Spanish child population was overwei-

The Ozempic phenomenon One of the main drivers of change in obesity is the commercialisation of new medicines. Social media and prescribers have made it possible to talk about one of the first viral medicines, with its supporters and detractors.

Although it was originally developed to treat diabetes, Ozempic is now one of the most popular tools for fighting obesity and has revolutionised the pharmaceutical industry.

According to the company, a person can lose up to 15% of body mass in a matter of months. Its active ingredient is semaglutide, which, among other benefits, regulates blood glucose levels, stimulates insulin release, reduces appetite and helps slow digestion.

This injectable medicine - along with a healthy diet and exercise - can also help reduce the risk of cardiovascular disease. But like any treatment, the dosage and duration of treatment must be prescribed by a doctor.

The importance of movement

ght at that time. And more recently, the World Atlas of Obesity 2023 warned that almost 400 million children will be living with obesity in 2035.

Keeping the heart safe

Cardiovascular diseases, mainly heart disease and strokes, are linked to this excessive accumulation of fat. Obesity can be seen as a prelude to many other chronic diseases. “Although it cannot be said that obesity in itself is strictly speaking a risk factor for cardiovascular disease, it is the cause of the appearance - or worsening - of several alterations that clearly predispose to cardiovascular disease,” explains Dr. Silvia Pons, cardiologist at Assistencia Sanitària and member of the Complementary Cardiology Explorations service at Barcelona Hospital.

These pathologies also include diabetes, high blood pressure and hypercholesterolemia. In fact, according to the Spanish Heart Foundation, obesity multiplies the chances of presenting other cardiovascular risk factors such as hypertension. In this regard, it is estimated that high blood pressure is 2.5 times more frequent in obese people than in people of normal weight.

Obesity reduces life expectancy as much as smoking, and it is the fifth leading cause of death in the world

To reverse this situation, it is important to encourage a good diet and emphasise the importance of physical activity. “Unfortunately, we cannot act on some cardiovascular risk factors such as age, gender and individual genetic predisposition, but we can modify others, such as cholesterol, sugar and blood pressure levels. A direct and beneficial effect of physical exercise has been seen in all of these, so maintaining adequate physical activity and avoiding a sedentary lifestyle would be key. This, together with a balanced diet, makes it possible to achieve and maintain a correct weight,” argues Dr Silvia Pons.

A joint approach is also essential in which the patient is not blamed and in which, in addition to establishing healthy lifestyle habits, the psychological consequences of the disease are addressed, as an example. Finally, there are several pharmacological and surgical treatments that can be used to combat obesity as a supplementary aid to diet. Dr. Pons explains that, currently, “a series of drugs called GLP1 analogues have appeared that have proven to be effective in reducing weight by reducing appetite”.

The cardiologist points out that their use without medical control can produce a rebound effect, and reminds us that, in the most serious cases of obesity, “there is the option of surgical treatment, which should always be carried out under the control of a specialised team”.

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Odontology

How to take care of oral hygiene for a

A

s the WHO suggests, most oral health conditions are preventable and can be treated in their early stages. In its Global Oral Health Status Report 2022, the WHO estimated that oral diseases affect around 3.5 billion people worldwide, with tooth decay being the leading condition. This is followed by periodontal diseases, tooth loss and oral cancers.

HEALTHY SMILE?

As Dr Teresa Vizuete, odontologist at ASISA Dental, explains, “oral health is a combination of our genetic predisposition and our habits. Proper hygiene is extremely important and should accompany us at all stages of our lives”. In the case of dental caries, it is the bacterial plaque on the surface of the teeth that converts free sugars contained in food and drinks into acids that destroy the tooth over time. “In children, it is typical to get emergency treatment due to baby bottle tooth decay (due to excess sugars in the diet).

94% of young adults (between 35-45 years) in Spain have caries, a percentage that increases to the entire population when they reach the age of 65 and questions the population’s commitment to their dental hygiene.

Decalogue for good oral health We should brush our teeth at least twice a day, and if possible three times a day (after the main meals).

We should never miss brushing after dinner, as during the night the flow of saliva decreases and we are less protected against the action of oral bacteria.

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Normally, we should visit the dentist once a year. If there is any pathology (e.g. periodontal disease) or any treatment that requires maintenance (e.g. dental implants), it is recommended to visit the dentist every six months.

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There are many toothpaste options on the market, depending on the patient’s needs: for gingival inflammation, for tooth sensitivity, for caries prevention, etc.

The odontologist is the best professional to advise if a specific type of toothpaste is needed.

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It is important to be careful with tooth whitening products, as an abraded enamel, in addition to producing sensitivity, will stain more easily, so the rebound effect will aggravate the situation. Nowadays, safe, effective and long-lasting whitening treatments can be carried out in the dental surgery.

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Mouthwashes are used temporarily to help recovery after certain treatments (surgery, extractions, etc.) or to combat periodontal pathologies (mainly those containing chlorhexidine in their composition).

However, it should be the dentist who indicates their use and for how long, as some can cause staining, taste alterations and other side effects.

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For adults, the pathology which affects most individuals from maturity onwards is periodontal disease (gum and bone problems that can lead to tooth loss)”.

There are 34 million people suffering from caries (4 million of them are children and 2.5 million are adolescents) and 5.2 million adults suffer from periodontal disease. Dr. Vizuete is clear: “If I had to identify the biggest enemy of our oral health nowadays, I would point to stress as the cause of poor hygiene caused by rushing, bruxism, smoking or dry mouth”.

Dr Teresa Vizuete Odontologist at ASISA Dental

We cannot guarantee that an implant will last for life, although its success rate is usually high. For this reason, it is very important that the patient with implants takes responsibility for their care, especially with good hygiene, regular check-ups and following the advice of the dentist.

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Both dental floss and interdental brushes are accessory tools for brushing to remove plaque between the teeth. It is important to clean these areas because they accumulate a lot of plaque, which can lead to cavities and gum problems.

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Food is one of the of the factors that generate bacterial plaque inside the mouth. Sweet foods, for example, promote the appearance of caries, and very acidic foods attack tooth enamel. It is essential not to consume too much sugar in the diet and to avoid tobacco and alcohol, which are also responsible for bad breath.

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It is important to bear in mind, she adds, that oral hygiene is not only involved in chewing, phonation or socio-emotional well-being, but also in the general state of health. “An oral infection can have systemic repercussions, especially in vulnerable people such as diabetics, patients with heart disease, immunocompromised patients and even cancer patients”.

Plaque build-up on the tongue, in addition to causing bad breath, can lead to oral infections and can aggravate common dental problems. Specially designed tongue cleaners are available in pharmacies, although a toothbrush is usually sufficient.

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Tartar cleanings (tartrectomy) are not only harmless to the enamel, but are periodically very healthy for gingival health. It is recommended to perform them once a year to remove dental calculus or mineralised mass adhering to the teeth that could not be removed by brushing.

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Active Life

THE SQUAT:

manual for a basic exercise

This exercise is considered the best we can do for our legs, to activate the metabolism and gain muscle mass in general. In addition, by doing it, we raise testosterone and growth hormone (GH) levels.

by María Pérez

E With your torso straight, descend until your thighs are parallel to your feet and bring your weight towards your heels 10

veryone has heard of them and, unconsciously, we do them repeatedly throughout our lives. Squats are one of the most complete and easy exercises available. They activate ankles, hips and knees, and develop muscles such as the calf and quadriceps, improving mobility and the execution of such everyday and necessary actions as climbing stairs or sitting down.

Apart from their well-known advantages for firming the glutes, they have countless benefits from burning calories to strengthening the cardiovascular system and improving posture and stability.

As Dr. Horschig, author of The Squat Bible, says, we need to move better before we move more, and that begins with implementing simple but complete exercises like these into our daily routine. Above all, it’s about strengthening our lower body muscles and ligaments to maintain a good physical condition that will allow us to avoid possible injuries or pain in the future. But where should we start? Definitely by perfecting the movement, which is essential before adding difficulty or intensity to any exercise. Here’s a little guide to mastering the art of the squat.

How to perform a basic squat correctly?

Place your feet shoulder-width apart, keep your eyes straight ahead and pull in your ab-

dominals. Keep your feet steady as you slowly descend, flexing your hips as if you were sitting on an imaginary chair and point slightly outwards. It is important to keep your torso straight. Lower down until your thighs are parallel to your feet and bring your weight towards your heels. Return back up to sit back up, activating your whole body.

Types of squat Isometric squat This involves holding the basic squat for a few seconds. It can be performed with your back against a wall if desired.

Barbell squat This consists of a basic weighted squat using a barbell supported on the trapezius muscles. It is important to keep the back and neck straight and adjust the weight correctly to avoid injury.

You can also practice this modality with the bar on the posterior deltoid or perform a front squat with the bar under the body.

Jump squat This involves doing a deep squat followed by a jump. It increases the difficulty of the strength exercise and has an important cardiorespiratory factor. The reception of the jump implies a greater impact on the knees, so it should be considered if any injury is present.

Pistol squat This involves doing a squat with one of your legs completely straight out in front of you. You have to focus all your strength and keep your balance with the one that is supported.

Bulgarian split squat To do this, place your foot on a support, such as a chair or step, at knee height, and stretch that leg backwards. The other leg should be lowered to a ninety-degree angle. This squat, by putting all the weight on one leg, works the quadriceps intensely and improves balance.

Sissy squat Specialists recommend doing five repetitions of ten squats a day, but if you are not physically active and this is too much, it is best to start with a number you are comfortable with. As with any new exercise, be aware of your body’s signals and stop at any pain or discomfort. For older people, it is recommended to exercise using a chair.

Strong legs are crucial to keep you moving, and squats are great for increasing leg strength.

This is a more challenging squat. A tribute to King Sisyphus from Greek mythology, it is recommended for more advanced levels. To perform this squat, you should lower yourself as low as possible, leaving the support on the tips of your toes. You must hold on to a support to avoid losing your balance. The torso is kept fully stretched and the abdomen, tight.

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Emergencies

What to do in case of BURN? When facing an injury of this kind, we will act according to whether they are: MINOR BURNS

SEVERE BURNS

1. S oak the area in running water

1. Analyze the condition of the area and the

(not cold) for about ten minutes.

If the burn is on a sensitive area (face, armpits, groin...) place a cool, damp cloth to relieve the pain.

2. I n case of blistering, do not

2. C all 112, the local emergency number,

3. I n the case of first-degree bur-

3. D o not attempt to remove clothing that

burst them. If it breaks naturally, clean the area with water and apply an antibiotic balm.

ns, look for a cream that helps skin regeneration and healing.

For second-degree burns, you will need to prevent and treat possible bacterial infections.

4. I n case the blisters have

broken, or the area can easily get dirty, cover the burn with a clean bandage, avoiding exerting pressure on the wounded area. If the pain persists, take an over-the-counter analgesic (ibuprofen or naproxen sodium).

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person injured. If you can help the person who was burned, remove the original cause of the burn. In case of an electrical burn, do not touch the person directly, but do it with a non-metallic object.

B

urns are injuries to the skin or other body parts caused by heat or due to radiation, radioactivity, electricity, friction or contact with chemicals, according to the WHO. These injuries destroy skin cells and their annexes, causing edema and fluid loss. They are one of the most common accidents happening at home and should be treated appropriately depending on the source.

From a sunburn up to one caused directly by fire, there can be a whole range of risk situations.

Classification of burns

• •

FIRST-DEGREE. They affect only the outer layer of the skin, causing pain, redness and slight inflammation.

or go to a medical center, depending on the condition of the person and the severity of the injury.

is stuck to the burn.

4. If the person is not breathing, artificial respiration and CPR should be administered.

5. C over the burn area with a sterile, dry

bandage. Avoid applying creams or popping blisters. The area should be protected from any possible pressure or friction.

6. W hile medical help arrives, elevate the injured body part above heart level, if possible.

•

S ECOND-DEGREE. They affect the outer as well as the underlying layer of the skin, causing the same symptoms as in the first case (pain, redness, swelling) and small clusters of lymphatic fluid known as blisters.

T HIRD-DEGREE. They affect the deeper skin layers, reaching down to the fat layer, and are known as full-thickness burns. The skin becomes whitish, dark or visibly burned and may become numb. Grafts are usually required to close the wound.

Compartir 13

Cooperatives and social medicine Strategy.Strategic plan for sustainable growth After learning of the results for the last financial year, Dr. Francisco Ivorra, President of the ASISA Group, emphasized that “the ASISA Group continued to grow in 2023 in a very complicated scenario, with high inflation rates and administrative mutual insurance premiums practically frozen. In order to achieve our objective and continue to grow and to develop our own healthcare network, we have had to make a major commercial effort while maintaining an ambitious investment plan.

We have also established the foundations for the transformation of our management model towards more profitable growth, the great challenge we will face in the coming years”.

The CEO of the ASISA Group, Dr. Enrique de Porres, during his speech at the Advisory Board held under the slogan “Always in motion”.

The ASISA Group increased its insurance premiums and its healthcare activity more than 4% in 2023 ASISA and ASISA Vida achieved a volume of insurance premiums of 1,487.67 million euros, while the healthcare companies, led by the HLA Group, had a turnover of 615.2 million euros.

In 2023 ASISA Group continued to develop its strategic plan, establishing growth as a major priority. The company achieved its growth target both in the insurance field, where it obtained a premium volume of 1,487.67 million euros, as well as in the assistance field, where its turnover reached 615.2 million euros. In both cases, growth was over 4%.

Results for 2023 were presented at the ASISA Advisory Board, which, under the slogan “Always in motion”, brought together the company’s top managers to analyze the evolution

of the different business areas and to establish its strategy for the next few years.

In both the short and medium term, ASISA’s priority for the ASISA Group will continue to be sustainable and profitable growth. In order to achieve this, the company will continue to promote the transformation of its commercial and management model; it will strengthen its healthcare capacity through the expansion and modernization of its own network, and will maintain its social and environmental commitment with the deployment of its ESG

In order to move towards more sustainable and profitable growth, the ASISA Group will continue to deploy its strategic plan, based on five main pillars: transforming its commercial model with the aim of strengthening its capacity for growth in the insurance sector, advancing in multi-branch diversification, improving the company’s profitability and developing its client portfolio; strengthening its own healthcare network; seeking new opportunities abroad to increase its international presence; accelerating its digital transformation process; and, lastly, making progress on its ESG commitments.

Regarding the latter, the group has increased the number of people it directly employs by almost 20% since 2018. In fact, Forbes chose ASISA, the HLA Group and Analiza among the 100 best companies to work for in Spain in 2023.

ASISA Life launches its first accident insurance with specific coverage for senior clients ASISA Vida has added to its product portfolio a new accident insurance policy designed specifically for people aged between 55 and 85. With this insurance policy, ASISA Vida Accidentes Senior, the company continues to make progress in the development of a flexible insurance offering, adapted to the particular needs of clients and providing high value for its policyholders.

ASISA Vida Accidentes Senior can be purchased in different options and it includes specific coverage ( severe burns, frac-

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tures, hospitalization due to an accident, etc.) and assistance services adapted to senior policyholders (post-hospitalization services due to accidents or home improvements, for instance).

Accordingly, Francisco Martínez Aguilar, Managing Director of ASISA Vida, explains that: “The well-known silver economy offers a great opportunity for ASISA Vida, which will continue to design products and services for a group that represents more than 20% of the population and which will continue to grow over the coming years”.

Promotional picture of ASISA Vida Accidentes Senior.

HLA El Ángel submits its certification as a teaching hospital HLA El Ángel Hospital received its certification as a teaching hospital at an event held at the hospital itself, a meeting which brought together leading figures from the Administration, civil society and healthcare from the province of Malaga and the country as a whole, including the President of the ASISA Group, Dr. Francisco Ivorra.

The HLA Group opened HLA Clínica Internacional Barcelona in 2023.

More than three million queries in 2023

Last year, the HLA Group attended 600,000 emergencies and performed more than 155,000 surgical interventions.

The HLA Hospital Group attended more than 3.1 million visits in 2023, 22% more than in 2022. The group’s expansion strategy, with the opening of new centers and units, its commitment to technological innovation and the incorporation of new professionals have allowed its healthcare indicators to grow in the last financial year.

During 2023, the group attended nearly 600,000 emergencies, almost 220,000 hospital admissions and more than 3,000 families chose HLA to give birth to their babies. It also performed more than 155,000 surgical procedures, almost 950,000 diagnostic imaging tests and 19.7 million laboratory tests.

In 2023, the HLA Group continued to reinforce its commitment to growth with the opening of its first clinic in Barcelona, HLA Clínica Internacional Barcelona, investing 24.8 million euros. The HLA Group also opened a new medical-surgical center in Seville, HLA Ramón y Cajal, in which it has invested 24 million euros and which has thirty multi-specialty clinics and four latest-generation operating rooms.

The openings in Catalonia and Andalusia, two priority regions in the HLA Group’s growth strategy, are joined by the new HLA Vistahermosa Elche medical center. The HLA Group has a total of 18 hospitals and 38 medical centers throughout the country and is also planning to open a new medical center in Alicante in 2024, where it will offer more than ten specialties and the latest technological and treatment advances. It has also just opened its first medical center in Extremadura.

The recognition as a teaching hospital, granted by the Health and Consumer Affairs Department of the Junta de Andalucía, will enable HLA El Ángel to take a further step forward in its commitment to the training of healthcare

professionals studying at the University of Malaga.

Dr. Ivorra thanked the hospital professionals for their efforts and emphasized that “the hospital is taking a step forward and assuming the responsibility of training the doctors of the future”.

The Secretary General for Public Health in Andalusia pointed out that “the HLA Group should feel very proud to have two university hospitals in Andalusia”, adding that “this is the greatest recognition that can be given to a hospital”.

New high performance assisted reproduction unit in Seville The UR International Group is growing in Spain with the inauguration in Seville of a new fertility center located in the HLA Ramón y Cajal medical-surgical center, opening its doors to patients in November. With the inauguration of this new center, the UR Group offers in Seville province the latest technology applied in reproductive medicine, as well as the most advanced fertility techniques and highly complex processes.

UR Seville offers highly complex treatments, personalized attention and quality in the procedures.

“Our center is equipped with the most modern technology and a team with extensive experience, backed by a long history based on excellence, quality care and commitment to the patient,” explains María Dolores Sánchez Quintana, medical director. The UR Group, which celebrated its 40th anniversary in 2023, offers the highest benefits to its patients with highly complex treatments, personalized attention and quality processes.

IV Painting Award with the collaboration of the ASISA Foundation The Royal National Academy of Medicine of Spain organizes its annual awards competition with the aim of publicly recognizing the work of Spanish medical professionals, including the Painting Award.

The theme of this year’s competition will be Portrait of D. Pedro Laín Entralgo. The paintings must be submitted to the RANME headquarters between May 20 and 31, 2024, and all the works presented will be exhibited in the rooms of the Royal Corporation’s headquarters from June 10 to July 15, 2024. The winner’s work will become part of the rich heritage treasured by this institution, remaining its property and being able to be exhibited temporarily or permanently.

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Cooperatives and social medicine

16th edition of the scholarship programmes for healthcare professionals Assistència Sanitària is now opening the application period for academic scholarships for the 2023-2024 academic year.

Applications for this grant can be submitted via the web form (www. asc.es) until 13 May and the results will be announced on 10 June. The call is an unmissable opportunity for students committed with their training and the progress of the healthcare system, who will receive an amount corresponding to 50% of the tuition fees, with a maximum of one thousand euros for each beneficiary.

The terms and conditions of the programme stipulate that grant recipients must be studying during the 2023-2024 academic year and may not have previously received another Assistència Sanitària scholarship.

Candidates must undergo the se-

lection process on the basis of their merits and abilities, with priority for academic excellence and a clear vocation to work in the healthcare or insurance sector. The Scholarship Tribunal assessing the process is composed by members of the Assistència Sanitària board and doctors from its medical staff.

The Assistència Sanitària Scholarship Programme represents an investment in Catalonia’s health care future. Through its constant support for students’ training and professional development, the organisation reaffirms its commitment to excellence and innovation in the field of healthcare.

Hospital de Barcelona improves its efficiency In accordance with the current legal requirements, the Hospital de Barcelona building has undergone and successfully passed the audit to renew its energy classification.

The exhaustive audit covers several aspects, such as energy consumption in cooling, heating, hot water and lighting, considering the intensity

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of use and the occupation of the different spaces.

In addition, last February the panels for the new photovoltaic power plant at Barcelona Hospital were assembled, the latest technology for a facility that will be a benchmark in its field. Hospital de Barcelona currently has an energy certification with a

A centre at the forefront of education and training Hospital de Barcelona has begun the year with the aim of consolidating a number of initiatives designed to enhance the reputation and continuous improvement of the hospital and its teams. In addition to the constant work of its teaching committee, the level of the internal sessions of the different specialities and the Monday sessions, which began a new cycle in March and are open to the general public, stands out.

Furthermore, the hospital has moved up the Newsweek ranking of the best hospitals in Spain 2024 and its professionals continue their expertise, receiving recognition and analysis in scientific publications. In this regard, Dr. Anicet Puigdollers is the author of an article on proctology in the Spanish journal Cirugía Española, and Dr. Jordi Morillas and Dr. Sandra Mechó have developed a new augmented reality solution to assist vascular puncture.

Collaboration with the Barça Foundation on World Cancer Day Coinciding with 4 February, World Cancer Day, Assistència Sanitària joined in recreational activities organised by the Barça Foundation.

Thanks to the insurer, the FC Barcelona basketball match against Valencia at the Palau Blaugrana was attended by families affected by this disease, who enjoyed an exciting and funny evening thanks to a solidarity initiative.

Partnership with the CMAB is strengthened Assistència Sanitària and the Association of Insurance Mediators of Barcelona are reinforcing an alliance which consolidates their commitment to mediation and focuses on groups and companies of varying sizes. As a result of this alliance, the distribution channel receives important benefits, in particular through support in terms of information and training and commitment to an offer of health insurance products recognised for their quality and for the satisfaction of the insured population. The agreement is also a recognition of the essential role that intermediaries play in providing professional advice, personal service and in-depth knowledge of the market and products.

Assisport is growing with new services The sports medicine centre of the entity has expanded its offer with three new services for physical care.

Assistència Sanitària has extended its range of services at Assisport, adding three new proposals to help its users to overcome obstacles and to achieve their desired performance goals.

Sports podiatry, which is essential to ensure the proper mechanical functioning of the foot and enable healthy and safe sporting activities, has added a service which incorporates a biomechanical study of running and movement, as well as the preparation and adaptation of customised insoles to improve the footprint and to reduce impact in order to prevent injuries.

Also new is the sports nutrition and supplementation service, which is based on

C grade - on a scale ranging from A to G - which has been revalidated with a slightly better score than the previous one.

This highlights that Hospital de Barcelona is constantly striving to optimise its energy efficiency and to reduce its environmental impact, which will be further improved in future revisions due to the implementation of the photovoltaic energy installation.

a balanced diet adapted to each individual. With a comprehensive approach, it includes different key components to achieve its objectives: kinanthropometry study, calorie expenditure test, complete analysis, dietary habits survey, supplementation, etc.

Hyaluronic acid infiltration, which has been a breakthrough in the treatment to prevent joint wear and tear and osteoarticular injuries, is the third of Assisport’s newly created services.

On the left, Joan Carles Díaz Meco, Assistència Sanitària’s Sales Manager; on the right, Francesc Santasusana, President of the CMAB.

The therapy prevents joint friction and reduces pain, inflammation and immobility, a frequent and highly prevalent concern among athletes.

The leisure and cultural programme of the SCIAS Participation Area

Further proposals for possible future improvements include the automation of the internal temperature according to the external temperature by adjusting the equipment.

Despite logistical difficulties and special considerations related to the hospital’s healthcare activity, the feasibility of implementing these proposals is being studied as part of the hospital’s ongoing commitment to sustainability.

The meeting point designed to enable SCIAS members to exchange ideas, learn more about their cooperative and participate in the annual assemblies has its physical space in the Participation Area, where numerous regular or one-off activities take place to promote proximity with the organization and the rest of the members. After the necessary adaptation to the digital era -especially during the pandemic-, the generational change and the growth of its users, it presented a new recreational and cultural program with varied proposals. Conferences, cooking workshops, concerts, trips, language courses and book presentations can be consulted on its website (www. scias-socis.com).

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Cooperatives and social medicine

New edition of the World Cooperative Monitor The Espriu Foundation is in the third place in the healthcare sector in terms of turnover.

What is the social and economic impact of cooperative enterprises worldwide? The World Cooperative Monitor, a study published each year jointly by the International Cooperative Alliance (ICA) and the European Research Institute on Cooperative and Social Enterprises (Euricse), aims to provide an answer to this question.

2023 edition, published on 25 January, compiles economic and social data on hundreds of cooperative enterprises and draws up a ranking according to their business volume. The 300 cooperatives with the highest turnover in the world accumulate a total of 2.4 billion dollars (2.2 billion euros), an increase of 11% on the previous year. At the top of this ranking is the French financial and insurance group Crédit Agricole and the German multinational REWE. The institutions linked to the Espriu Foundation, which consolidate their figures for this study, are in 205th place.

The study also draws up a sectoral ranking, based on the main activity of the cooperatives analysed. In the healthcare sector, the Espriu Foundation is in third place in terms of turnover, behind the Brazilian doctors’ cooperative Unimed and the US-based Health

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Partners users’ cooperative. The Monitor’s ranking according to the economic status of the countries where the cooperatives analysed operate is also of interest.

Considering the per capita income of the countries, the study compares the relative size of the enterprises in their own context. Two Indian companies stand out at the top of this ranking: the agricultural holding company IFFCO and the livestock company Gujarat Milk.

Looking at the economic sector in which the 300 largest cooperatives operate, 35% belong to the insurance sector and 32% to the agri-food sector. Geographically, 55% are located in Europe, 32% in America and 13% in Asia.

The World Cooperative Monitor is available at this link:

More qualitatively, the Monitor takes a closer look at the cooperative identity of large enterprises, and examines the veracity behind some of the criticisms about the difficulties that large cooperatives have in maintaining the participative dynamism of cooperative members. The report also compiles a wealth of evidence on how large cooperatives explicitly maintain and communicate their cooperative identity, and how this is reflected in concrete benefits that bring added value to cooperative members when compared to the consumer or worker in a classic enterprise.

The transition to a social economy On 12 and 13 February, the conference centre of the city of Liège (Belgium) hosted a new European Social Economy Meeting.Representatives of social economy enterprises, institutional leaders and academic experts debated the role of these companies in the inclusive, green and digital transitions, including the need to attract young talent and to address the ability to respond to today’s major challenges, with the aim of building a more social and sustainable Europe.

The meeting, which was a follow-up to the conference organised by the Ministry of Labour and Social Economy last November in San Sebastian, was held under the title The social economy at the centre of transitions.

The agenda included three plenary sessions dedicated to each transition, six best practice workshops, and four round tables discussing public policies and strategies, state aids, integration of social economy and the access to funds.

The meeting concluded with the signing of the Liège Roadmap for the Social Economy in the European Union, which expands on last year’s San Sebastian manifesto and contains the agreement of 19 EU social economy ministries in order to promote this sector on the continent.

These commitments include the promotion, creation and development of curricula and training centres dedicated to the social economy and social entrepreneurship; and the creation and development of master’s degrees, chairs and research-action programmes in the social economy at universities.

Governments are also committed to stimulate the creation of statistical tools adapted to the social economy, at local, regional, national and European level, in order to support the collection of data and surveys that specifically detail the reality of the social economy and give a more accurate picture of its ecosystem and its impact.

At the event, an inclusive, green and digital transition of companies related to the social economy was discussed.

Headquarters of the United Nations.

International Year of Cooperatives The United Nations has declared 2025 as the International Year of Cooperatives, in a new resolution that joins those recently adopted with the aim of promoting social economy and enterprise models, such as cooperatives, which contribute to progress towards the 2030 Agenda’s Sustainable Development Goals. Once again, it recognises the significant impact that cooperative enterprises have on economic and social development, especially in terms of job creation, social integration and poverty reduction.

After the successful first International Year of Cooperatives in 2012, the UN calls on member states to use 2025 to promote the cooperative economic model and to raise public awareness of its contribution to sustainable development.

The resolution also encourages states to analyse good practices and consult with cooperatives on existing legislation and public policies in order to ensure that the national legal and regulatory environment is the most supportive to the creation and growth of cooperatives, by improving existing laws and regulations or enacting new ones, especially with regard to access to finance, autonomy, competitiveness and taxation.

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In depth

The future is here: the age of

ARTIFICIAL INTELLIGENCE The incredible possibilities offered by the application of this new technology are both astonishing and inevitably uncertain. However, in the field of healthcare, it can be used to push training, research or care to a new level, promoting personalised and predictive medicine.

by Enric Ros

“I am more concerned

about human stupidity than artificial intelligence”. This resounding statement was made by the founder of the Artificial Intelligence (AI) Research Institute of the Spanish National Research Council (CSIC), Ramon López de Mántaras, in an interview published in La Vanguardia on 10 September 2023. The strength of his words was intended to rebut - or, at least, to clarify the fear of a technology that is currently growing exponentially. In the same conversation, this prestigious professor and researcher did not hesitate to add: “The problem is not Frankenstein’s monster. The problem is Dr. Frankenstein”, thus putting the responsibility in the court of human beings.

In any case, the shocking irruption of AI into our lives has awakened atavistic fears of change, which - as Rubén Cruz, co-founder and creative director together with Diana Núñez of The Clueless, a company specialised in designing AI avatars for brands, points out - were already there before: “When the first calculators appeared, they generated protests among teachers. And when cameras started to be used, some said they could steal our souls. Juan de Dios Llamas, Chief Data Officer & Strategist at advertising agency BBDO & Proximity, points out that “by default, people tend to oppose advances. Any new technology generates an almost Luddite movement of reaction to the fear of the unknown”. .

A technology within reach of all

The ethics of the AI

“For a long time, data professionals used the internet in the wrong way,” says Llamas. It was a time when it was possible to extract data from internet users without having to ask for permission. In recent years, much progress has been made in defending users, as confirmed by the Spanish Data Protection Law, “one of the most advanced in this field”. The expert explains that many generative AI models “are trained with transparent information, which we can get to know, but others still operate as real black boxes”.

“Generative intelligences make Obviously, the new possibilities that the massive of AI require the creation of specific easier to communicate incorporation regulations. Content generated by bots is already exponentially at Google. “As anyone with machines without multiplying can access this technology, it is logical that this will to creative and beneficial uses for everyone, as having to speak in lead well as some more negative ones. The risk is that we will reach a point where we will no longer be able code”

Actually, AI is not as new as we think it is. In recent years, it has already been part of our lives, although we could only perceive the end result, as for example with the recommendation algorithms of

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platforms such as Netflix, Amazon or Instagram. Now, at last, technology has come out of the “ghetto” of data scientists to become accessible to anyone. And it is precisely at this moment that we are becoming aware of its infinite possibilities and its risks. “The boom in generative intelligences”, Llamas tells us, “it means that we can communicate with machines in natural language, without the need to speak in code, and we can obtain results that were unimaginable just three years ago”.

to differentiate reality from fiction,” Llamas comments. Rubén Cruz, in turn, believes that “there are new problems, such as possible impersonations, but also innumerable advantages. That is why we must create frameworks that promote the development of the latters”.

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In depth

DO ANDROIDS DREAM

of human intelligence?

The work environment is one of the main fields of application of AI, due to the optimisation of resources. However, the future predicts a radical transformation in the way work is conceived.

Cinema has insisted

on offering a catastrophic vision of robots and artificial intelligence in our lives. Stanley Kubrick’s 2001: A Space Odyssey (1968) narrated the rebellion of the great cybernetic brain HAL 9000; Ridley Scott’s Blade Runner (1982) - adapting Philip K. Dick’s science fiction story Do Androids Dream of Electric Sheep? - showed replicants who came to emulate humans in their most intimate dilemmas, such as the fear of mortality; and Spike Jonze’s more recent film Her (2013) reflected the particular relationship between an introverted, taciturn man and a seductive operating system as a symptom of a certain contemporary loneliness.

Many voices today talk about the possibility that AI could take jobs away from people. Rubén Cruz is convinced that “it will have an impact on certain fields such as science and arts, but above all it will serve to complement our work”. To explain the capabilities of this technology, he appeals to the famous superhero movies of the Avengers saga: “AI is like the robot called Ultron, a kind of superhuman who, thanks to the powers of the Mind Gem, draws on all human experience”.

An effective co-pilot

Juan de Dios Llamas is convinced that AI will have a “co-pilot” function: “Above all, it will be an assistant that will have an impact on all sectors and will allow many more tasks to be carried out. However, we have not yet reached the next stage, that of a general AI that knows everything and can do anything better than a human being. This is a horizon that is still some time away, maybe three years or so, but which can more radically transform our conception of work,” he adds. It is undoubtedly an uncertain scenario, but full of exciting options, which - as we will see below - may have some of their most interesting, and even revolutionary, applications in scientific fields such as medicine.

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“We are not yet at the next stage, where a general AI knows everything and can do anything better than a human being”

The ‘influencer’ who never was Virtual soul Virtual soul. This is how Aitana López, an influencer who, at the time of writing, already has 299,000 followers on Instagram, describes herself. But Aitana is different from other celebrities who attract a great deal of attention on this social network. Aitana is not actually “human”, but has been generated with artificial intelligence. Her “parents” are the young designers Rubén Cruz and Diana Núñez from Barcelona-based agency The Clueless.

As Cruz explains, their mission is to “create AI models that can promote brand products for certain market niches and to invent characters that serve as an image for a specific company”. The advantages are obvious: Aitana never gets sick and is never “caught” by the paparazzi at an inopportune moment; she doesn’t even need logistical investments, such as plane tickets or hotel rooms, to always appear fresh and shiny in photographs.

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In depth

PRECISION medicine

The benefits of AI impact on many of the sector’s work processes, ensuring that human needs are satisfied and that they operate with transparency at all times.

About ten years ago, Ignacio Medrano was

a young neurologist who, while working at the hospital, could already realise that artificial intelligence was about to materialise in his area of work. It was then that he began to imagine a project that would end up materialising with Savana, the company he co-founded with the intention of bringing AI to medicine. “We wanted to use data and computational mathematics to gain a better understanding of diseases, both descriptively, i.e. about the present, and predictively, i.e. about the future,” he says.

His goal was, first of all, to have large amounts of well-ordered and “clean” data - “Big data should be clean data”, he says - to develop a clinical AI, which the doctor could ask questions about, for instance, the response to a certain drug in a group of patients. In his opinion, “the change that this implies is huge”. Although it may still be slow, it will clearly shake up the inertia of healthcare systems: “We are moving towards precision medicine, where we will be able to specify which drug, and at what exact dose, is needed for a given genome.

Towards a predictive model

Soon, AI is expected to begin to radically transform some specialties, such as radiology. Josep Munuera, director of Radiodiagnostics at the Hospital de Sant Pau, agrees with Medrano that to achieve this, “it is essential to digitalise the data, as it has been the case with medical imaging for more than a decade”. Later on, Munuera hopes that “AI will be applied to other fields, such as clinical history or pathological anatomy. Undoubtedly,” he adds, “it will help automate processes and standardise the way we work. And it will contribute decisively to making more rigorous and informed decisions.

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Main uses of AI in healthcare

It accelerates drug discovery by predicting the effectiveness of certain compounds.

It personalises medical treatments and provides continuous care through telemedicine and virtual assistance.

It improves precision in surgeries, both in the training field and in the forms of support during real procedures.

It reduces industry costs by reducing errors and supporting clinical and administrative workflows.

This will even make it possible to anticipate the patient’s possible illnesses, a scenario that is not without some moral doubts. As Julio Mayol, Professor of Surgery and Head of Surgery at the Hospital Clínico San Carlos in Madrid, points out, “the possibility of predicting a disease has tremendous social and ethical implications”. Faced with the inevitable fact that “technology will end up completely changing the way the healthcare model is organised”, Mayol proposes “a great social alliance of professionals and the healthcare system itself to commit to the appropriate and constructive use of AI”, always to benefit patients.

Accelerating knowledge

“The ability to predict disease has tremendous social and ethical implications”

Ignacio Medrano is convinced that the role of doctors in the near future will be to use algorithms to draw conclusions about their patients’ health. This means training new professionals, with extensive knowledge in medicine and also in technology (“Stanford is already teaching AI to their doctors”, confirms this neurologist and entrepreneur).

It will also be “a powerful vehicle for accelerating research, in fields such as rare diseases, or for designing new types of drugs, thanks to the capacity of technological engines to exploit and analyse data and obtain different results to those we have had until now”, says Josep Munuera.

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In depth

The importance of preserving

THE HUMAN FACTOR

Current applications of AI in medicine focus on the use of machine learning models to search medical data and to improve the patient experience.

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Although it may initially

seem a paradox, technology can be used to build an even more humane medicine. Josep Munuera points out that it will probably “help to overcome the limits of communication between patient and doctor, helping to translate information or managing appointments efficiently”. At the same time, by allowing greater precision, “it will help speed up diagnoses”, which could lead to greater efficiency in the health system as a whole.

Munuera is fully convinced that, in the age of AI, “the role of the doctor must be more than ever focused on the human aspects, such as careful examination of

and communication with the patient”. Freed from certain more bureaucratic or less valuable tasks, the healthcare professional will be able to regain a more humanistic dimension. At the same time, technological support “will require new regulation to provide clear answers to new dilemmas, such as who owns the intellectual property of a medical decision in which AI has been involved”.

Julio Mayol, on his side, believes that we cannot yet calculate how far all these new tools that will be implemented in the near future will bring us (at present, “we don’t know that we don’t know”, he says). Ignacio Me-

“In diagnostic specialties, a large part of the procedure will be automated”

drano considers that human culture is not yet ready for a massive landing of AI in all aspects of existence, however, he is truly enthusiastic about the possibilities it may bring in medicine.

“Perhaps in diagnostic specialties, the presence of people will not be as important as before, as much of the procedure will be automated,” he explains. “But in any case, the human being will still be a crucial factor in the whole process. The contributions of our intelligence will also be relevant in those clinical judgements that require counterfactual thinking, where alternatives which do not coincide with what it is suggested by the data will be considered”.

In any case, the move towards data-driven healthcare has many advantages (a healthcare attention based on data). It will encourage collaboration between specialists and will prevent patient referrals through unproductive visits.

It will facilitate the creation of drugs and combinations of drugs to be used in more and more specific situations and cases. And in general, we could say that it will make a decisive contribution in many areas of hospital practice, from patient care to precision surgery with robots, as well as the efficiency of early detection or clinical trials. Science-fiction dystopias have time and again portrayed AI as a dangerous Big Brother, but if we use it wisely, it can be an excellent ally in taking medical care and patient healthcare to a new dimension.

Working as a team A research study in Los Angeles, published in the prestigious science journal Nature in April 2023, tested the effectiveness of artificial intelligence in analysing up to 3,500 echocardiograms. The cardiologists involved in the project certified that they found it impossible to distinguish which tests had been analysed by humans and which by AI. Another study in Germany, published in The Lancet in July 2022, found that collaboration between doctors and AI improved breast cancer diagnosis results.

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Destinations

Lombardy glamour:

ROUTE THROUGH THE LAKES From the stately Lake Como to the mysterious waters of Iseo, the luminous Garda or the elegant ‘Lago Maggiore’, this northern Italian province is home to a multitude of unique natural scenery.

by Neus Duran

A

ristocrats, Hollywood stars, composers, famous writers and millionaires; since the time of ancient Rome, when nobles chose its shores to build their opulent summer villas, Lake Como has made everyone surrender to it. It is, along with the Maggiore, the best known of Lombardy’s lakes, but the Italian region hides many others whose beauty is spectacular. Although they can be visited by public transport, the most attractive option is undoubtedly to embark on a route by car to discover them freely and with total flexibility.

With some of the deepest waters on the continent and the Alps as a backdrop, Como is littered with villages and mansions that have appeared on the big screen, such as Villa del Balbianello, in the small town of Lenno, which was the idyllic retreat of Princess Padmé and Anakin Skywalker in Star Wars. Attack of the Clones, as well as the elegant resort where James Bond recuperated in Casino Royale. Lake Como was also the location for George Clooney’s Ocean’s Twelve, and the actor was so fascinated by the place that he bought a spectacular villa

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and became one of its most illustrious neighbours.

One of the must-see lakeside towns is beautiful Bellagio, with pastel-coloured houses, gardens everywhere and steep lanes lined with glamorous boutiques and luxurious restaurants. Its biggest rivals in terms of elegance are Tremezzo and Varenna; in the former, don’t miss a stroll through the spectacular botanical gardens of Villa Carlota, part of the Great Italian Gardens circuit, while the latter fascinates with its picturesque fishermen’s cottages.

Through a drawbridge

Over Lake Garda, Italy’s largest and one of its most popular lakes, a small peninsula is home to charming Sirmione, reached by a drawbridge leading to the gate of the medieval castle of Sclaigero. With its ever-vibrant streets, its little stone houses with flowery balconies, its famous thermal centre and the Roman caves of Catullus, it has become a top tourist destination. For those who are more active, the largest of Italy’s lakes has a wide range of water sports on offer, as does Lake Maggiore, which Lombardy shares with Switzerland and

Against the backdrop of the Alps, Como is a real film set that has been portrayed many times on the big screen

the Piedmont region. The latter is home to the lake’s main attraction, the exquisite Borromean Islands, which can be visited with a combined pass and where you can admire the baroque and rococo palaces and English-style gardens with more than 2,000 varieties of exotic plants.

The fascinating solitude of Monte Isola

Lake Iseo is much less well known and more affordable, shrouded in mystery and with sites such as a neo-Gothic castle on the tiny islet of Loreto. Just a short ferry ride from the shores of the lake will take us to the secluded island of Monte Isola, which is just three kilometres long and has a population of 2,000.

Peschiera Maraglio, an ancient village of fishermen and artisans, welcomes the traveller to this island where there are no cars: only the doctor, the mayor and the priest have their own; the rest of us have to go by small bus or motorbike. The best plan is to discover it on foot or by bicycle along a circular route that is suitable for all levels of fitness and, if you wish, to stay in one of the island’s charming establishments.

If travelling with the family, a good choice is Endine Lake, which has bathing areas, barbecue and picnic tables. It is surrounded by green hills where it is possible to go hiking, paragliding or mountain biking to round off a perfect getaway.

Above, the neo-Gothic castle perched on the tiny islet of Loreto in Lake Iseo; below, the ever-vibrant and glamorous Lake Como.

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Collecting

Technology, nostalgia and pop: keys to the boom in

COLLECTING

Once they were everyday objects, they helped us to communicate, to find our way around and to make certain tasks more bearable.

Now they find their place among collectors, witnesses to a time that, although it may seem distant and gone, refuses to be forgotten.

by Joan Miquel Mas Salom

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I

n a certain sense, understanding our life involves understanding our relationship with the objects that surround us. Objects are with us as long as we use them, and then we discard them or jealously guard them. Some stay with us forever, like in direct contact with a memory, a time, a person or a place. Since we were kids, we want to accumulate objects that give us an identity, that challenge us and that define us.

A human quality

Accumulating objects, collecting them, is another facet that distinguishes people. Collecting, in this sense, is almost as old as humanity itself. Since the earliest civilisations, human beings have accumulated and cared for objects, whether to preserve the memory of a family or the heritage of a culture. But it was not until the Modern Age that it acquired the meaning we give it today. The desire to recover lost objects of Greco-Latin culture in Renaissance Italy coincided in time with the discovery and conquest of America. Two elements, the tradition and the exotic, awakened an interest in accumulating and cataloguing small and large treasures. What was initially a hobby of the aristocracy gradually spread to all levels of society, and many private collections would end up in national museums. From

When we get that missing piece, our brain rewards us by releasing dopamine. dynasty, commissioned by the Qianlong Emperor in the 18th century and valued at 79 million euros; numismatics (coin collecting), with objects such as the 1933 Double Eagle gold coin, which was sold at an auction for 18 million euros, and bibliophilia, where the Codex Leicester, a 72-page manuscript written between 1506 and 1510 by Leonardo da Vinci, bought by Bill Gates in 1994 for 28 million euros, is particularly noteworthy.

Analogue nostalgia and pop culture

Over the last few years there has been a boom in retro technology collecting. Typewriters, analogue cameras and even that Walkman that accompanied us in the grunge era are now coveted by collectors. One example is a Leica Series 0 camera, a limited edition of 25 made in 1923, which was sold for more than two million dollars.

the 20th century onwards, collecting expanded and broadened its horizons.

But the reason why humans collect things is also answered psychologically. Our brains need to set guidelines and goals, and when we achieve them, we are rewarded with pleasure. When we finally find that unpublished piece, that out-of-print book or that prop from our favourite film, our brain rewards us by releasing dopamine.

Exclusivity and luxury

While we can find collections to suit all budgets, it is true that there are types of collecting that stand out from others because of the enormous cost of their objects. Art collecting, of course, is where its items acquire the most value. Paintings such as Pablo Picasso’s Les femmes d’Alger, valued at 164 million euros, Paul Cézanne’s The Card Players, valued at 229 million euros, or Leonardo da Vinci’s Salvator Mundi, discovered in 2008 and valued at 412 million euros, are at the top of the world’s most valuable collector’s items. This is also the case in antique car collecting, with 44 million euros paid for a 1962 Ferrari 250 GTO Berlinetta; in antiques, with a Chinese vase vase from the Pinner Qing

The world of vinyl is also one of the fastest growing sectors. Exclusive and limited editions can cost thousands or even millions of dollars, as in the case of Wu-Tang Clan’s Once Upon a Time in Shaolin, sold for almost two million euros, or The Beatles’ Yesterday and Today, whose first copies are valued at nearly one million.

However, pop culture is the biggest collector’s hobby today. Comic books, comics, old consoles, Funko Pop, toys, film posters, costume objects or props... The variety is enormous and it represents the fastest growing niche in collecting. Some of its elements can cost very high amounts, such as the 31 million euros paid for Marilyn Monroe’s dress in The Seven Year Itch or the million euros that collector Ralph DeLuca paid for one of the four original posters of Fritz Lang’s film Metropolis.

Interested in collecting?

We are creating a community of collectors among the readers of Compartir magazine. We want to facilitate communication and exchange between philatelists, numismatists and all kinds of collections. If you want to participate, scan this QR code and leave us your contact details. We will send you information about our project and our activities.

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Trends

‘THE PRODUCERS’:

Mel Brooks’ cult classic returns

From box office flop to Broadway smash hit, ‘The Producers’ has become the most awarded show in history. Now, after its success in Barcelona, the version adapted by Àngel Llàcer and Manu Guix lands in Madrid.

by Salomé Lagares

I

n the last five years, the duo formed by Àngel Llàcer and Manu Guix has brought some of the most famous musicals in history to national stages. Starting with their adaptation of La jaula de las locas in 2018, they have been stringing hits together with the irreverent delirium of La tienda de los horrores (2019) and the undeniable magic of Cantando bajo la lluvia (2021). Observing this triumphant trail, their new proposal seems at once an inevitability and a somewhat risky bet: The Producers, the singular satire by the legendary filmmaker Mel Brooks, released as a film in 1967 and made into a play in 2001.

At a first glance, the plot seems simple: Max Bialystock (played by Armando Pita), a ruined theatre producer whose plays do nothing but fail, discovers through his histrionic, repressed accountant, Leo Bloom (Ricky Mata), that if he raises a large amount of money to produce a lousy play and puts it on for a much smaller budget, he can keep the extra money for himself when it’s cancelled after a few performances, as the tax

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office never investigates shows that fail.

So Bialystock and Bloom, now a neophyte producer, undertake the task of finding the worst script ever written and producing the biggest flop in Broadway history.

The text turns out to be Flowers for Hitler, an ode to the Führer written by an exiled ex-Nazi pigeon farmer (Jose Luis Mosquera), and the way to turn it into an even bigger disaster is to recruit Roger de Bacle (Àngel Llàcer/Oriol Burés), affected, volatile and stubborn, as director.

it takes to raise 1,000% [of the budget] to put on a Broadway show?

The same concern could be transferred to the Spanish public, but any worries are silenced when contemplating the project’s grandeur: with a cost of 2.7 million euros, an ambitious two-level set design, a team of 24 actors and dancers and a live orchestra, The Producers is the biggest show Llàcer and Guix have ever created, and, during its 6 months of performances in Barcelona, it became one of the most watched musicals of the season. .

It is easy to guess how much of its mordacity and genius, elements that make The Producers captivating and incredibly funny, are also precisely those that make it a daring and divisive work, and a somewhat audacious proposition for Llàcer and Guix: a cast of eccentric and ridiculous characters, the satirization of a character like Hitler, the meta-commentary on the intricacies of the theatre industry... Mel Brooks himself admitted in an interview with Vanity Fair in 2004 that “they saw it in the big cities, but would people in Kansas understand what

Their triumph is a consequence of the quality stamp that this duo has turned their names into, but also due to the spectacular nature of the particular proposal and how well it fits their creative vision: the work is both iconoclastic and a celebration of theatre, outrageous and self-aware at the same time. Now, with 12 weeks of performances (so far) at Nuevo Teatro Alcalá in Madrid, The Producers has the opportunity to consolidate the success achieved in Barcelona and become a badge in the band worn by this theatrical team.

A comedy ahead of its time The germ of the original script was, precisely, the fictional musical: Flowers for Hitler. This is the provocative answer Mel Brooks gave when a journalist asked him what his next project was going to be. Soon after, Brooks became obsessed with leaving television, where he had made his career almost exclusively, and Flowers for Hitler became the project that would allow him to make the leap to cinema.

What makes ‘The Producers’ a captivating and entertaining piece also makes it a divisive work

The story was met with a lot of no’s for its pitch, but a name change got the necessary yeses: from producers Sidney Glazier and Joseph Levine, and from its stars, Zero Mostel and the as-yet little-known Gene Wilder. By then, Brooks was so embedded in the film’s DNA that no one else could have directed it, and what followed was an absolutely dreadful shoot, with an extremely tight budget and schedule and constant clashes of egos threatening to completely dynamite the film.

Nevertheless, the film overcame the obstacles to make it to the cinemas, but failed miserably at the box office. Time, however, has honoured it, and it has steadily achieved cult classic status for its undeniable wit, forward-thinking humour and mustsee comic performances by Mostel and Wilder.

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Disconnection

Did you know...?

A soldier removed his own bladder stone in 1782

Books

Recovering ecology As ecologists Paul Jepson and Cain Blythe show, rewilding is a new and progressive approach to biosphere conservation, combining radical scientific ideas with practical innovations to revive ecological processes, benefiting both people and nature. Its goal is to restore lost interactions between animals, plants and natural disturbances, elements that constitute the essence of thriving ecosystems.

Rewilding. Paul Jepson & Cain Blythe, Ed. Icon Books.

Living better to live longer

In 1782, Claude developed the symptoms of a bladder stone and decided not to visit a doctor, as the operation usually performed in such cases was extremely painful and could leave serious after-effects.

B

ladder stones affect approximately 10% of the population in industrialised countries, increasing their incidence between the age of 40 and 60.

The non-invasive procedure currently used to destroy these hardened masses is known as lithotripsy and was first performed in the 18th century by someone who practiced it on himself.

Claude Martin was a soldier who spent much of his life working for the British East India Company. His military success became so great that he ended up as the richest European in India. Among his many hobbies, he was known for his interests in science and medicine.

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Instead, this soldier designed a homemade instrument with a knitting needle and waxed threads and a whalebone shaft, which he inserted into the urethra to scrape out the stone, bit by bit, in different interventions. He did this for six months, several times a day, until the symptoms disappeared.

And, in the light of his success, he sent details of the operation to the London Company of Surgeons.

Half a century later, French surgeons created an instrument very similar to Claude’s to perform transurethral lithotripsy at Necker Hospital in Paris, although they were apparently unaware of this achievement. Today, shock waves are often used to disintegrate stones in the kidney and parts of the ureter.

In this groundbreaking manifesto on how to live better and longer, Dr Peter Attia, currently considered one of the foremost experts on longevity, proposes different nutritional actions, techniques to optimise physical exercise and sleep, and tools to improve our lifestyle. What role does exercise, nutritional biochemistry or emotional health play in the longevity we live?

Sin límites. Peter Attia & Bill Gifford, Ed. Gaia Ediciones.

A scientific guide to weight loss Dr. Marián García (Boticaria García) presents a book to find out how a revolutionised microbiota, poorly exercised muscles and cortisol directly affect the metabolism. Tu cerebro tiene hambre approaches weight loss from an informative and entertaining point of view, using the best endocrinologists in the country and the latest international scientific studies. A reading that also uncovers five major changes in habits to help you lose fat and be healthier.

Tu cerebro tiene hambre. Boticaria García, Ed. Planeta.

Y, de repente, llegó el susto.

Y cuando te recuperaste, llegaron también otras cosas: Llegó volver a miraros a los ojos, y los paseos largos, y esa conversación honesta con tu hermana.

Llegó el momento de leer todos esos libros que te esperaban, y bailar en la cocina un martes por la mañana, y sentarte a comer.

Llegó tu nueva bici, y las sobremesas con tu padre.

Y descubrir que el árbol que siempre estuvo en tu calle es un almendro y da una flor preciosa en marzo o que el panadero tiene un hijo que es un as en matemáticas.

Llegó jugar con tus hijos pensando en jugar con tus hijos.

Llegó esa nueva forma de tomarte la vida.

¿Y si no esperamos al susto para vivir como queremos vivir?

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