This article argues that the misalignment of private profit-maximizing objectives with public health needs causes institutional corruption in the pharmaceutical sector and systematically leads firms to act contrary to public heath. The article analyzes how financial incentives generate a business model promoting harmful practices and explores several means of realigning financial incentives in order to foster therapeutic innovation and promote the rational use of medicines.

This paper explains how the current architecture of the pharmaceutical markets has created a misalignment of financial incentives and public health that is a central cause of harmful practices. It explores three possible solutions to address that misalignment: taxes, increased financial penalties, and drug pricing based on value. Each proposal could help to partly realign financial incentives and public health. However, because of the limits of each proposal, there is no easy solution to fixing the problem of financial incentives.

The definition and measurement of social welfare have been a vexed issue for the past century. This book makes a constructive, easily applicable proposal and suggests how to evaluate the economic situation of a society in a way that gives priority to the worse-off and that respects each individual's preferences over his or her own consumption, work, leisure and so on. This approach resonates with the current concern to go 'beyond the GDP' in the measurement of social progress. Compared to (...) technical studies in welfare economics, this book emphasizes constructive results rather than paradoxes and impossibilities, and shows how one can start from basic principles of efficiency and fairness and end up with concrete evaluations of policies. Compared to more philosophical treatments of social justice, this book is more precise about the definition of social welfare and reaches conclusions about concrete policies and institutions only after a rigorous derivation from clearly stated principles. (shrink)

English summary: The authors invited eighteen artists and theorists to reflect on what is meant by contemporary photography and contemporary art. Historical issues or paradigmatic problems? The articulation of these eighteen points of view, sometimes radically different, can have a fruitful view on issues, concepts, assumptions, and current issues on the subject. French text. French description: Francois Soulages et Marc Tamisier ont invite dix-huit artistes et theoriciens a reflechir sur ce qu'ils entendent par photographie contemporaine et par art contemporain. (...) Questions historiques ou bien problemes paradigmatiques? L'articulation de ces dix-huit points de vue, parfois radicalement differents, permet d'avoir un panorama fecond sur les problematiques, concepts, presupposes et enjeux actuels sur le sujet. L'enjeu premier serait-il l'" art-contemporain " qui ne se reduirait pas alors a l'art qui serait contemporain. Que serait, alors, la " photographie-contemporaine " a l'ere du numerique? L'enjeu ultime est bien le/notre contemporain! (shrink)

BackgroundThe ageing of the population and the increased number of chronic diseases are associated with an increased frequency of end of life care in hospital settings. Residents rotating in hospital wards play a major part in their care, regardless of their specialty. General practitioner (GP) residents are confronted to such activities in hospital settings during their training. Our aim was to know how they feel about taking care of dying patients, as end-of-life care are very different from the clinical activity (...) they are trained to.MethodsWe surveyed all GP trainees of “Ile de France”. The survey was made of 41 questions regarding advanced directives divided in 7 sections about patients’ care, communication, mentoring and repercussion on personal life. The survey was done one time, during two pre-specified days.Results525 residents (53.8%) accepted to fulfill the survey. 74.1% of the residents thought that palliative care could have been better. Possible ways of improvements were: a reduction of unreasonable obstinacy (or therapeutic overkill, two terms defined in French law as curative treatment without reasonable hope of efficiency) (59.6%), patient’s (210 answers, 40%) and relative’s communication (information of patients and relatives about the severity of the disease and risk of death) (199 answers 37.9%). Residents also reported a lack of knowledge regarding end-of-life care specific treatments (411 answers, 79.3%) and 298 (47.2%) wished for better mentoring. Those difficulties were associated with repercussion on their private life (353 answers, 67.2%), particularly with their close relatives (55.4%). Finally, 56.2% of trainees thought that a systematic psychologic follow up should be instituted for those working in “at risk” hospital settings.ConclusionSelf-perception management of dying patients by GP resident emphasize their lack of training and supervision. The feeling of suboptimal care is associated with consequences on personal life. (shrink)

Les médias ont longtemps exercé un contrôle sur le discours public pouvant les concerner. Cela n’est plus le cas. Elle est révolue l’époque où la critique des médias pouvait très difficilement se faire entendre sur la place publi­que, dont les journalistes étaient les gardiens incontournables. Jusqu’à récem­ment, les médias dominaient le jeu et sélectionnaient les sources qui les criti­quaient publiquement. Ils pouvaient exercer une sorte de monopole de l’autocritique en se dotant de dispositifs d’autorégulation , dont l’efficacité, l’indépendance et la (...) crédi­bilité sont mises en cause dans plusieurs pays. Avec Internet et l’interactivité pro­pre aux médias sociaux, plus rien ne peut endiguer le flot de critiques. Les médias ne peuvent plus prétendre que l’autorégulation suffit à assurer la qualité et l’inté­grité de l’infor­mation, puisque leur production souffre de carences rapide­ment décelées par les citoyens, que l’on doit désormais considérer comme des agents de la corégulation. (shrink)

Les relations de la machine et de la pensée sont aussi anciennes qu'énigmatiques, toujours en attente d'une solution. C'est un mythe dont s'abreuve la philosophie. Il est ici repris en fonction de notre conjoncture, la science-fiction avec Matrix, la logique et l'ordinateur avec Turing, enfin l'élaboration théorique avec le cognitivisme et la non-philosophie. Ces essais ont été élaborés dans un même esprit au sein d'une équipe dont les jeunes philosophes partagent le désir commun de renouveler le style philosophique par une (...) discipline de philo-fiction. -/- The relationship between the machine and thought is as old as it is enigmatic, always awaiting a solution. It's a myth that philosophy feeds on. Here it is revisited in the context of our current situation: science fiction with Matrix, logic and the computer with Turing, and theoretical development with cognitivism and non-philosophy. These essays have been drawn up in the same spirit by a team of young philosophers who share a common desire to renew the philosophical style through a discipline of philo-fiction. (shrink)

The diversity of bone proteoglycan (PG) structure and localisation (pericellular, extracellular in the organic bone matrix) reflects a broad spectrum of biological functions within a unique tissue. PGs play important roles in organizing the bone extracellular matrix, taking part in the structuring of the tissue itself as active regulators of collagen fibrillogenesis. PGs also display selective patterns of reactivity with several constituents including cytokines and growth factors, such as transforming growth factor‐β or osteoprotegerin thereby modulating their bio‐availability and biological activity (...) in the bone tissue. In this review, the complex PG composition in bone will be addressed together with the specific role played by PGs (or their GAGs chains) in bone biology, as regulatory molecules for bone resorption and their involvement in bone tumor development. These roles have been determined after modulation of PG expression or mutations in their corresponding genes, which revealed specific roles for these compounds in bone pathologies (e.g. perlecan or glypican‐3 mutations observed respectively in chondrodysplasia or dysmorphic syndrome). Finally, the potential therapeutic interest of PGs is discussed based on recent data, more particularly on bone tumor‐associated osteolysis as these molecules are involved both in bone resorption and tumor development. BioEssays 29:758–771, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

In this paper, we consider how the four key team emergent states for team learning identified by Bell, Kozlowski and Blawath (2012), namely psychological safety, goal orientation, cohesion, and efficacy, operate as a system that produces the team’s learning climate (TLC). Using the language of systems dynamics, we conceptualize TLC as a stock that rises and falls as a joint function of the psychological safety, goal orientation, cohesion, and efficacy that exists in the team. The systems approach highlights aspects of (...) TLC management that are traditionally overlooked, such as the simultaneous influence of and feedback between the four team emergent states and the inertia that TLC can have as a result. The management of TLC becomes an issue of controlling the system rather than each state as an independent force, especially because changing one part of the system will also affect other parts in sometimes unintended and undesirable ways. Thus the value is to offer a systems view on the leadership function of team monitoring with regards to team emergent states, which we term team state monitoring. This view offers promising avenues for future research as well as practical wisdom. It can help leaders remember that TLC represents an equilibrium that needs balance, in addition to pointing to the various ways in which they can influence such equilibrium. (shrink)

Languages show substantial variability between their speakers, but it is currently unclear how the structure of the communicative network contributes to the patterning of this variability. While previous studies have highlighted the role of network structure in language change, the specific aspects of network structure that shape language variability remain largely unknown. To address this gap, we developed a Bayesian agent‐based model of language evolution, contrasting between two distinct scenarios: language change and language emergence. By isolating the relative effects of (...) specific global network metrics across thousands of simulations, we show that global characteristics of network structure play a critical role in shaping interindividual variation in language, while intraindividual variation is relatively unaffected. We effectively challenge the long‐held belief that size and density are the main network structural factors influencing language variation, and show that path length and clustering coefficient are the main factors driving interindividual variation. In particular, we show that variation is more likely to occur in populations where individuals are not well‐connected to each other. Additionally, variation is more likely to emerge in populations that are structured in small communities. Our study provides potentially important insights into the theoretical mechanisms underlying language variation. (shrink)

Passive Brain-Computer interfaces (pBCIs) are a human-computer communication tool where the computer can detect from neurophysiological signals the current mental or emotional state of the user. The system can then adjust itself to guide the user towards a desired state. One challenge facing developers of pBCIs is that the system's parameters are generally set at the onset of the interaction and remain stable throughout, not adapting to potential changes over time such as fatigue. The goal of this paper is to (...) investigate the improvement of pBCIs with settings adjusted according to the information provided by a second neurophysiological signal. With the use of a second signal, making the system a hybrid pBCI, those parameters can be continuously adjusted with dynamic thresholding to respond to variations such as fatigue or learning. In this experiment, we hypothesize that the adaptive system with dynamic thresholding will improve perceived game experience and objective game performance compared to two other conditions: an adaptive system with single primary signal biocybernetic loop and a control non-adaptive game. A within-subject experiment was conducted with 16 participants using three versions of the game Tetris. Each participant plays 15 minutes of Tetris under three experimental conditions. The control condition is the traditional game of Tetris with a progressive increase in speed. The second condition is a cognitive load only biocybernetic loop with the parameters presented in Ewing et al. (2016). The third condition is our proposed biocybernetic loop using dynamic threshold selection. Electroencephalography was used as the primary signal and automatic facial expression analysis as the secondary signal. Our results show that, contrary to our expectations, the adaptive systems did not improve the participants' experience as participants had more negative affect from the BCI conditions than in the control condition. We endeavored to develop a system that improved upon the authentic version of the Tetris game, however, our proposed adaptive system neither improved players’ perceived experience, nor their objective performance. Nevertheless, this experience can inform developers of hybrid passive BCIs on a novel way to employ various neurophysiological features simultaneously. (shrink)

The doctor-patient relationship has evolved to respect “the autonomy and patients’ rights”. One of the cornerstones in such autonomy is the opportunity for patients to draw living wills, also known as advance directives. However, information about AD available to patients remains scarce largely due to the lack of involvement of General practitioners for several reasons. The aim of our study was to evaluate current general practitioner residents’ behavior concerning their role in informing their patients about AD. We built a French (...) nationwide survey from GPR class of 2012 to 2014. Two thousand three hundred ten residents completed our survey. 89.8% declared their willingness to offer patients the opportunity of writing AD. When asked about the usefulness of AD, 73.6% of residents responded that these are a suitable help for patients, but 19.7% considered that AD are essentially geared towards frail patients. Among residents who want to inform patients about AD, 14.7% wanted to involve all patients. Only 20.5% thought that elderly people should be systematically informed about AD. When the question involves other frail people in various disease areas, information seems relevant for 60.1% of GPR considering patient with cancer or malignant hematologic disease and for 56.2% about patients affected by neurodegenerative disease. When considering the routine use of AD, 20.5% of GPR would take them into account only if they are in agreement with the patient’s decision. The results of the survey indicate that GPR would rather choose to decide who should be informed about AD, and when to take AD into account for ethical concerns. (shrink)

English summary: Schelling's Die Weltalter was frequently announced as ready for publication, but little of the book was ever written. Schelling planned Die Weltalter as a volume in three parts, describing the past, present, and future of the world; however, he began only the first part, rewriting it several times and at last keeping it unpublished. The other two parts were left only in planning. French text.French description: « Commencé seulement les Ages du monde ». Cette note que Schelling consigne (...) dans son Tagebuch à la date du 27 décembre 1810 donne le coup d'envoi d'un des projets les plus grandioses qu'un philosophe se soit proposé, retracer sur la base de concepts philosophiques les étapes de la vie divine et de la création. S'il est vrai, comme le disait Novalis, que « vouloir écrire une Bible est un penchant à la folie que tout homme doit avoir pour être complet », cette grande fresque cosmique et théologique représente la tentative la plus magistrale qu'ait menée l'idéalisme allemand pour rendre compte de la totalité de la manifestation divine et en proposer une présentation effective et complète. Or, dans la dernière version de l'ouvrage, celle-là même que Schelling fit introduire dans ses Sammtliche Werke et dont nous donnons ici une nouvelle traduction dans la continuité de celle des brouillons de 1811 et 1813, le récit et la construction spéculative cherchent encore à atteindre un point d'équilibre. Un double effort pour implanter la succession au coeur même de l'Absolu tout en équilibrant en Dieu les rapports de l'idéal et du réel prépare l'avènement d'une philosophie historique sans ue l'on débouche jamais tout à fait sur une hétérogénéité radicale de l'être et du penser. Ainsi, à travers cette description du passé le plus archaïque, Schelling met pour la première fois effectivement la philosophie en possession de ce qu'elle recherche depuis toujours : « la science, c'est-à-dire l'histoire ». (shrink)

New concepts may prove necessary to profit from the avalanche of sequence data on the genome, transcriptome, proteome and interactome and to relate this information to cell physiology. Here, we focus on the concept of large activity-based structures, or hyperstructures, in which a variety of types of molecules are brought together to perform a function. We review the evidence for the existence of hyperstructures responsible for the initiation of DNA replication, the sequestration of newly replicated origins of replication, cell division (...) and for metabolism. The processes responsible for hyperstructure formation include changes in enzyme affinities due to metabolite-induction, lipid-protein affinities, elevated local concentrations of proteins and their binding sites on DNA and RNA, and transertion. Experimental techniques exist that can be used to study hyperstructures and we review some of the ones less familiar to biologists. Finally, we speculate on how a variety of in silico approaches involving cellular automata and multi-agent systems could be combined to develop new concepts in the form of an Integrated cell (I-cell) which would undergo selection for growth and survival in a world of artificial microbiology. (shrink)

Daylight is the primary cue used by circadian clocks to entrain to the day/night cycle so as to synchronize physiological processes with periodic environmental changes induced by Earth rotation.However, the temporal daylight pattern is not the same every day due to erratic weather fluctuations or regular seasonal changes. Then, how do circadian clocks operate properly in varying weather and seasons? In this paper, we discuss the strategy unveiled by recent studies of the circadian clock of Ostreococcus tauri, the smallest free‐living (...) eukaryotic organism. It combines mechanisms controlling light inputs and clock sensitivity, shaping both the dynamics of the core circadian oscillator and its forcing by light so as to ensure stable and precise synchronization in all weather and seasons.Editor's suggested further reading in BioEssays: Another place, another timer: Marine species and the rhythms of life Abstract. (shrink)